News
Scottish government review backs plans for national care service
The Scottish government’s review of adult social care has recommended the creation of a statutory National Care Service on an equal footing with NHS Scotland to raise standards following the pandemic. The recommendation is the key plank in
the independent review, chaired by former Scotland director general of health and social care Derek Feeley, commissioned by Holyrood last September ahead of Scottish elections in May. The review found accountability for
social care support should move from local government to Scottish ministers, with the creation of a social care minister. The National Care Service would work in
close co-operation with the NHS to “establish a simplified set of outcome measures to measure progress in health and social care support”. A chief executive would be appointed to
the National Care Service, equivalent to the chief executive of the NHS and accountable to ministers. The National Care Service would oversee
local commissioning and procurement of social care and support by reformed Integration Joint Boards, with services procured from local authorities and third and independent sector providers. Integration Joint Boards would manage
GPs’ contractual arrangements, whether independent contractors or directly employed, to ensure integration of community care and support provision, to respect and support professional interdependencies, and
to “remove the current confusion about where responsibility for primary care sits”. The review’s recommendations also
include an end to charging for non-residential services so that social care can be free at the point of need for those receiving care in their own homes or community settings. In addition, it calls for enhanced pay, conditions, training and support for the social care workforce. “In her Programme for Government speech that launched this review, the First Minister said ‘This is a time to be bold’. The good news is that everyone we spoke to agrees with her,” said Feeley. “What follows is a plan for how. It will take
time. It has taken over 50 years for our current system to form. It will take investment. It will take partnership,” he added. “But we have an opportunity to create
a system of social care support where everyone in Scotland has the opportunity to flourish. If not now, when?” Trade association Care Scotland gave
strong support to the findings of the review. “The review rightly argues for a dramatic revolution in the way in which we commission and procure social care services,” it said. “We need to strip out competition and
replace it with collaborative, responsible and ethical approaches which include those who are the primary purchasers of care – citizens themselves.” Care Scotland however noted the lack of financial detail about the costs of creating a National Care Service in the review.
Trial to test drugs for reducing Covid severity
A trial funded by the National Institute for Health Research will look at reducing the transmission of Covid-19 and its severity in care homes. As part of the University of Nottingham-led PROTECT (Prophylactic Therapy in Care Homes Trial), up to 400 care homes will test drugs that already show promise for treating Covid-19, but use them to prevent Covid-19 instead. They are focussing on care home
residents due to their higher risk from Covid-19, and although priority has been given to them for vaccination, the effectiveness of vaccines in this group has not yet been fully established. The aim is to reduce the number and severity of Covid-19 in those homes. If PROTECT can identify an effective
drug to reduce transmission and severity of the virus, then this, alongside other measures, could help enable a return to a more normal life for residents and their families, including more liberal visiting policies. Lead researcher, Professor Philip
Bath, said: “Apart from vaccines, there are no drugs for preventing serious Covid-19 and we believe that the PROTECT trial has a good chance of finding one or more drugs that might reduce the awful death rates seen in care homes.” The £1.7m trial will have a ‘platform’
structure, like the recent RECOVERY trial, which rapidly evaluated candidate treatments for Covid-19 and previously found that dexamethasone reduced death in hospitalised patients with severe Covid. PROTECT however will randomise
care homes rather than individual residents to one of up to three drugs or no additional treatment, in a cluster- randomised controlled design. This design allows several drugs to
be tested in parallel and for new drugs to be added once older ones have been shown to be beneficial or have no useful effect. The drugs are understood to be include common treatments for other conditions including heart disease, pancreatitis and asthma.
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www.thecarehomeenvironment.com • March 2021
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