A National Care Service for Scotland

Closed 2 Nov 2021

Opened 9 Aug 2021

Feedback updated 21 Jun 2022

We asked

The Independent Review into Adult Social Care (IRASC) recommended the establishment of a National Care Service, with Scottish Ministers being accountable for the delivery of consistent and high standards in health and social care services.

The Scottish Government undertook a public consultation on its proposals for a National Care Service (NCS) to achieve changes to the system of community health and social care in Scotland with the consultation running from the 9 August 2021 until the 2 November 2021.

The purpose of these proposals is to reform social care to ensure that we consistently deliver high quality care and support to every single person who needs them across Scotland, including better support for unpaid carers, and to ensure that care workers are respected and valued. The consultation was a key step towards shaping primary legislation to establish a NCS to achieve these changes.

The consultation sought views on:

  • improving how care is planned and delivered in practice, including rights to breaks from caring and non-residential care charges
  • the role and remit of the National Care Service
  • what might be included in the scope of the National Care Service
  • how Integration Joint Boards will be reformed to become Community Health and Social Care Boards
  • ethical commissioning and improving the commissioning of care across Scotland
  • improving regulation and scrutiny
  • valuing and supporting people who work in social care

You said

We received responses from 1,291 respondents. Two thirds of responses (67%) were made through the Citizen Space portal (862) and 500 were submitted by email or post. Of the email and postal responses, 407 were from organisations and 80 were from individuals (including responses in the Easy Read format). The total number of organisation email responses included 71 written responses that were provided in addition to a consultation form response, these have been considered as one respondent for the purposes of tallying the overall total of 1,291. It was also clear from some organisational responses that they had undertaken surveys or other engagement activities in order to respond to the consultation, and were therefore representing the views of a number of people.

The consultation process itself attracted a substantial number of comments and many respondents highlighted issues such as the length of the consultation questionnaire, the relatively short space of time in which they could prepare a response; the lack of detail around the proposals; and the nature of some of the questions which were thought to lead the respondent to a particular answer.

A summary of the main findings of this consultation are provided in the published independent analysis of the National Care Service Consultation.

We did

We pledged to begin the consultation process on a National Care Service (NCS) within the first 100 days of Parliament and to set up a social covenant steering group that would include people with living and lived experience of social care. Both of these pledges have been met.

The Social Covenant Steering Group is made up of people who access and deliver social care support and has been established to review plans for co-design and engagement, ensuring that lived experience and the views of people are central in the development of the National Care Service. The steering group held its first meeting on 20 July 2021.

A Key Stakeholder Reference Group has also been established, the purpose of which is to bring together a range of experts and practitioners to provide advice, scrutiny and challenge on proposed process, design and delivery plans, as well as providing best practice to inform those processes for design and delivery of the National Care Service.

The Group’s role will be to support the Programme by providing external stakeholder views and making recommendations to inform the policy in relation to the National Care Service.

We have published responses to the consultation, where we have permission to do so and an independent analysis of the consultation responses.

The feedback received during the consultation process has now been analysed and the conclusions have been used to shape and develop new legislation (a bill) which was introduced in the Scottish Parliament in June 2022.

We are committed to delivering a National Care Service by the end of this parliamentary term that will ensure the quality, fairness and consistency of provision of social care services  meets individuals’ needs, regardless of where they live in Scotland.

Published responses

View submitted responses where consent has been given to publish the response.


This consultation sets out our proposals to improve the way we deliver social care in Scotland.

The importance of our social care services has never been clearer than during the pandemic. In future, we want to make sure that our social care system will consistently deliver high quality services to everyone that needs them, throughout Scotland. Social care is an investment in our communities and our economy. We want to change the system from one that supports people to survive to one that empowers them to thrive, with human rights at the heart of it.

Social care includes support for people with physical disability, learning disabilities or mental health conditions, older people and those with dementia, people with or recovering from alcohol or drug addictions, those who are, have been or are at risk of being homeless, and children and families who may need additional support, or where children are unable to live with their own families.

The Independent Review of Adult Social Care recommended the creation of a National Care Service, with Scottish Ministers being accountable for adult social care support. However, the Scottish Government’s ambition is to go beyond that. This consultation therefore seeks views on creating a comprehensive community health and social care service that supports people of all ages.

We propose that the National Care Service will define the strategic direction and quality standards for community health and social care in Scotland. It will have local delivery boards which work with the NHS, local authorities, and the third and independent sectors to plan, commission and deliver the support and services that the people of Scotland require.

Our proposals will also take forward recommendations of the Independent Review of Adult Social Care around:

  • ensuring that care is person-centred and human rights based
  • providing greater recognition and support for unpaid carers
  • improving conditions for the workforce
  • commissioning for public good, and
  • more effective approaches to scrutiny and improvement of social care services.

Read the consultation paper.

Alternative formats of this consultation are also available, including Easy ReadBritish Sign Language and Audio . Other accessible formats are available upon request. To request those, please email: NCSconsultation@gov.scot.

If you require a paper copy to be sent to you, please email us or call our automated phone service on 0300 244 2425.

Why your views matter

This consultation focuses on exploring the proposals for significant cultural and system change that will need to be supported by primary legislation.  The Independent Review of Adult Social Care made clear that changes to systems are needed to deliver improvements in the quality of social care and support. 

The priority in considering these proposals must be improving outcomes for the people who access care and support. 

We want to hear views from as many people as possible to shape a better future – including people who access care and support, carers, members of the workforce and those who may access care and support in the future - which includes everyone. We want everyone who may be affected by these changes to have an opportunity to comment on them.

Consultation events

A series of online engagement events are being held in August, September and October to enable stakeholders, individuals and communities to come together to share their views on the National Care Service.

Some of these events will cover all aspects of the consultation, and some will be themed towards specific aspects of the consultation. These consultation events will offer people the opportunity to come together to discuss the National Care Service, and to understand the need for change within social care. A summary report will be produced from each event for the Scottish Government to consider alongside the official consultation responses. 

Find details below for events and registration.

NCS Consultation Engagement Event – All aspects of the Consultation: 26 October 2021 – 09:30 – 11:00 Click here to register

NCS Consultation Engagement Event – All aspects of the Consultation: 2 November 2021 – 10:00 – 11:30 Click here to register

Zoom Engagement Sessions

We are running a number of consultation engagement sessions on Zoom. If you would like to attend one of these sessions, please email NCSconsultation@gov.scot

Role and Remit of NCS: 25 October 2021 – 16:00 – 17:00

All aspects of the Consultation: 01 November – 11:00 – 12:30

All aspects of the Consultation: 02 November – 12:00 – 13:30

What happens next

At the end of the consultation process all of your feedback will be analysed and the conclusions will be used to shape and develop new legislation (a bill) which will be introduced in the Scottish Parliament in summer 2022. 

As we reach conclusions on the National Care Service we will continuously consider how it will integrate with the National Health Service and any implications for the NHS. We will also consider the impact of our proposals on equality groups and others, including businesses and island communities and will carry out a suite of impact assessments before finalising the proposals.

The legislation is likely to be extensive and complex and is likely to take at least a year to be scrutinised by the Parliament. After that we need to set up the organisation and put the legislation into effect. We intend the National Care Service to be fully functioning by the end of the Parliamentary term.



  • Health and Social Care