
Professor John Robertson OBA
In the Daily Telegraph, 24 November 2025:
SNP ministers decided to create their much-delayed Scottish NHS app from scratch after being warned against the “political optics of adopting” the existing English version. An assessment prepared for the Scottish Government on whether to “re-use” the English NHS app admitted that it was an “already usable and scalable digital platform”.
It’s not clear who did the above assessment nor is it likely that the Telegraph is reporting all of it’s views give that they have missed a key factor – integration with social care services.
Perhaps reflecting England’s failure to properly develop and integrate social care services, it’s not surprising that they neglected to bother with it for their app but things are different in Scotland.
Is social care in Scotland better developed and integrated with the NHS than in England?
Yes, social care in Scotland is both more structurally integrated with the NHS and more comprehensively funded and delivered than in England. This is not just a matter of degree; the two countries now operate fundamentally different models.Key Structural Differences
| Aspect | Scotland | England |
|---|---|---|
| Integration legislation | National Health and Social Care Integration (2014) – legally mandatory | Health and Care Act 2022 – permissive, voluntary Integrated Care Systems (ICSs) |
| Governing bodies | 31 statutory Integration Authorities (IJs) that control both NHS and local authority social care budgets | 42 Integrated Care Boards (ICBs) control NHS budgets only; social care remains with local authorities |
| Budget control | Single pooled budget for adult health + social care in each area | NHS and local authority budgets remain legally separate; pooling is optional and rare |
| Free personal care | Yes since 2002 (ages 65+), extended to under-65s with eligible needs in 2019 | No – means-tested only |
| Charging for non-personal care (e.g., domestic help, day centres) | Much lower / often free after Frank’s Law reforms | Means-tested with full cost recovery common |
| NHS Continuing Healthcare | Effectively abolished – long-term care needs met via integrated system | Complex, adversarial eligibility process remains |
Practical Outcomes (2023–2025 data)
| Metric (adult social care) | Scotland | England |
|---|---|---|
| % of over-65s receiving personal care at home for free | ~100 % of those assessed as needing it | ~14 % (only if eligible for NHS Continuing Healthcare) |
| Delayed transfers of care (bed-days per 100,000, 2024) | 350–450 | 900–1,200 |
| Unmet need for social care (Age UK / independent estimates) | Lower (~8–10 % of older adults) | Higher (~20–25 %) |
| Self-funders in care homes | ~15–20 % | ~40–45 % |
| Local authority social care spending per head (65+) 2023/24 | £650 | £420 |
For sources (62) see: https://x.com/i/grok?conversation=1997619840811487605

Thank you for this John.
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Telegraph up for sale. Being integrated into the Mail group. Disappearing right wing Press. Lie, after lie. Unbelievable.
No readers. Going down the tube. Along with the BBC propaganda. Biased and dishonest.
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Ah but the Telegraph, sorry the New Mail will now have such luminaries as Alan Cochrane whose latest missive in the New Mail is “Glaswegians have never been able to master English”.
There we have it, Alan knows, so Farage was right all along.
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Key in your quotation from the article is the weasel word with my emphasis ” An assessment prepared for…. “
It’s pretty obvious from the Simon Johnson article https://archive.ph/LDoiT that his source of the ‘assessment’ was Scotland’s Tory contingent, with rentaquote Damn Baillie bringing up the rhetorical rear for Gulhane’s latest piece of contrived nonsense, but there remains the question of who wrote the ‘assessment’.
You need scroll to near the end of this tripe before the validity of this ‘assessment’ becomes clearer, again with my emphasis – “A Scottish government spokesman said: “The business case referred to was not written by the Scottish Government – The full business case for the Digital Front Door programme has been prepared by NHS Education for Scotland. We are now fully reviewing and scrutinising it “
The politics of grievance, courtesy of a preening part time doctor and full-time propagandist….
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