How to Make a Country Care – Performance Measurement Frameworks as Drivers of Care Policy Change

The COVID-19 pandemic highlighted the longstanding social care crisis across the United Kingdom. The need for thorough and sustained change in the entire policy domain of care – defined as paid care workers, including childcare workers, and unpaid carers and those experiencing care – is clear. To achieve such change, the prominence of care as a key policy issue needs to increase. This could be achieved through care becoming anchored in outcomes-based performance measurement frameworks. A number of countries, regions or municipalities use such frameworks, for example in relation to health, the environment, or inequality, and often do so in the guise of ‘wellbeing frameworks’. Scotland, in 2007, introduced the National Performance Framework (NPF) This article presents how a ‘blueprint’ for a new Outcome on Care in the NPF was developed by a team of academic researchers, using a policy review and stakeholder interviews and following participatory action research principles. While the campaign which advocated the inclusion of care in the NPF was ultimately not successful, the article argues that the blueprint can inform discussions on how to embed care firmly in the considerations of policy makers, in Scotland and beyond. It also argues that performance frameworks offer opportunities for a visible celebration of policy success and the identification of barriers to improvement and that they can provide a positive focus to sustain systemic efforts to create ‘countries that care’.