Plans for a National Care Service in Scotland could see the ‘disintegration’ of the partnership built up in the local care sector according to the body set up to oversee social care in East Ayrshire.

East Ayrshire's integration joint board (IJB), which oversees the work of the area's health and social care partnership (EAHSCP) between the council and health service, is expected to deliver a strong joint response to the Scottish Government’s plans for a nationwide care service along the lines of the NHS.

The issue was discussed at a meeting of the board on Wednesday.

There has been considerable opposition to the plans in East Ayrshire since the outset, with major concerns that the area's positive work will be dismantled and services compromised.

One of the main concerns is what is seen as a dismissal of the positives that can come from a successful partnership by the Scottish Government.

East Ayrshire's HSCP only came into force in 2014, with the IJB put in place in 2015.

East Ayrshire Council leader Douglas Reid, who chairs the IJB, said: “We don’t deny the reason behind the bill is to improve quality of social work and social care services. That is something we all want.

“We really are disappointed that there is no reflection of where integration has worked well.

"We know that performance is inconsistent across the country but I didn’t hear any leaders from other council areas saying this was the solution.

“For ourselves, integration has worked well and we can see positives we’ve achieved. This will damage some of the positive strides we have made.”

The report to the IJB highlighted a number of areas of concern, stating that:

- East Ayrshire HSCP services go beyond requirements and include vital services such as children and young people’s social work and health services, justice social work and health services, and the area's alcohol and drug partnership.

- the possible fundamental and unintended consequences for communities and workforce could cause considerable disruption

- there is a risk of reduction in the quality of services as well as a ‘disintegration of mature, strong partnership working and delivery’

- the proposals could lead to an erosion of local accountability and democracy

- a national ‘one size fits all’ approach would fail to adequately reflect and meet the needs of different areas and populations

- a perceived lack of clarity around the finances and expected additional costs

- Scottish ministers will effectively have power to transfer staff and property from councils to a new centralised NCS, risking a reluctance to invest in these areas

- the adverse impact of national commissioning on local flexibility in procuring services, local employability and third sector local provision.

The IJB's draft response continued: “We believe that there are still too many questions and unknown factors for the consultation to be one which is fully informed.

“There is also a significant possibility that any transitional arrangements would risk a reduction in the quality of services currently being delivered in areas such as East Ayrshire, as well as a disintegration of mature, strong partnership working and delivery models.”

The response also criticises the lack of opportunity to make improvements within the current system, despite evidence of success in East Ayrshire.

It also highlights the success of the area's HSCP in providing early intervention and prevention, including reducing hospital admissions, delayed discharges and increasing support to people in their communities.

The response states: “East Ayrshire has consistently performed well with no delayed discharges locally over a two week period for a number of years.

“Central to this success has been the autonomy to develop local services based on identified local need through community engagement and participation.

"We are concerned that the National Care Service will erode or eliminate the ability to take this community focused approach to meeting the needs of those we serve.”

It also questions how the reform would work to support ‘The Promise’ – the commitment to ensuring children are ‘loved, safe, and respected and realise their full potential’ - or how the NCS would ‘drive quality improvement in care homes, ensuring that quality and standards come before profit’.

The IJB's draft response will also be considered by East Ayrshire Council on August 25 before a final version is agreed.

A Scottish Government spokesperson said: “The National Care Service is the most ambitious reform of public services in the devolution era. It will end the postcode lottery of care provision across Scotland and ensure those who need it have access to consistently high-quality care and support so they can live a full life, wherever they are.

“A key focus of the proposals is that services will be designed and delivered locally, including by local care boards, whilst ensuring ministers are ultimately accountable.

"We will work closely with people who rely on these services to ensure that the National Care Service meets their needs.

“Locally-employed staff will continue to have an important role to play in commissioning and delivery and we will continue to work closely with local authorities, the workforce and unions to ensure that the impact on staff of any changes is fully considered.  

“At the same time, will also work to improve the pay and terms and conditions for those who work in social care, embedding the fair work agenda to build a workforce that is fit for the future and delivers the best possible service for the people of Scotland.”