More than 200 third sector health and social care leaders have signed an open letter to the First Minister calling for immediate steps to address the current crisis threatening the sector.

Published on 17th August in the Herald on Sunday, the letter makes clear that without action now, the consequences of the crisis will be felt across society, from deepening inequalities to even greater pressure on the NHS and public services – with Scotland’s most vulnerable individuals and families paying the price.

Led by the Health and Social Care Alliance Scotland (the ALLIANCE) and the Coalition of Care and Support Providers in Scotland (CCPS), and supported by hundreds of its members, the letter makes four key asks of the Scottish Government:

·   An immediate, substantial cash injection in the upcoming Spending Review, including full cost recovery for employer National Insurance increases

·   A medium-term fully-funded recovery plan for the sector, to address decades of underinvestment

·   Multi-year funding agreements adjusted for inflation, to ensure stability for organisations

·   A firm commitment to fully include the sector in planning and decision-making

The Scottish Government’s recent announcement on reform sets out a commitment to change in the health and social care sector based on the Christie principles, from the widely-supported 2011 Christie Review.

These principles of empowerment, integration, prevention and efficiency provide a blueprint for what public services should be for and how they should be structured.

While the third sector supports these commitments, the reality is that they cannot be delivered without urgent, targeted investment in the very organisations expected to implement the changes.

Evidence from the ALLIANCE and CCPS lays bare the severity of the pressure currently facing the sector, and why the Scottish Government’s ambitions cannot be achieved without investment and stability:

• In a March 2024 survey by the ALLIANCE, nearly half (49%) of the member organisations that responded reported their financial position as "insecure".
   
• A February 2025 poll by CCPS found that 67% of not-for-profit providers are relying on financial reserves to stay afloat – and of these 91% say they will cease to be viable within four years if that trend continues.
   
• Recent data from SCVO shows that 81% of voluntary organisations are facing financial pressures that threaten essential services – an increase of 10% from 2023.

The ALLIANCE and CCPS are committed to working with the Scottish Government to achieve the key asks outlined in the letter.

Read the letter and calls in full here