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It’s time for a ‘carer-friendly’ NHS

24 September 2014

Heléna Herklots,
Chief Executive, Carers UK

The NHS depends on carers; without their contribution in unpaid care, it would collapse. But many carers feel that they aren’t being fully supported by the NHS either in their caring role, or to look after their own health.

The NHS Commitment to Carers, launched in May this year, is an important step forward in making carers a priority for the NHS. But there is a very long way to go. Our research found that a third of carers report positive experiences of NHS services, but with half of carers saying that their experiences of NHS services are only mixed or fair, and 1 in 6 describing them as bad or terrible, much more must be done to create an NHS that works for carers.i

The NHS has a unique role to play in helping carers to get the support they need. Many carers in the UK are caring alone, missing out on vital information, advice and support, and falling into long-term financial hardship and being unable to look after their own health and wellbeing as a result. In fact, the Census shows that full-time carers are twice as likely as non-carers to be in bad health, and more than half say that money worries are taking a toll on their health. This is unsustainable, and when carers’ own health deteriorates or they reach breaking point this can have a serious impact on them, their families, and the economy when they can no longer go on.

These carers are often not in contact with social care services and may not know there is help available – but they are in touch with the NHS, visiting GP surgeries and hospitals with the person they look after or as a patient themselves. A GP can make all the difference just by remembering to ask the person sitting in front of them if they look after someone and talking to them about what would help.

It’s not just carers who stand to gain from a carer-friendly health system. Carers are often experts in the health and care need of the person that they care for. Talking to carers about decisions affecting the person they look after makes life easier for everyone – the professional benefits from the carer’s valuable knowledge and experience, the older or disabled person has their needs met more safely and fully, and the carer’s life is made easier when they know what is going on.

That is why Carers UK is proposing a new ‘carer-friendly NHS’ programme – to ensure that carers are respected and involved in decision making, and that they get the advice and information they need, both from hospitals and primary care services. With the general election coming up in May next year, political parties are finalising their offer to the electorate. An NHS that works for carers should be a key element of this.

So what do we mean by a ‘carer-friendly NHS’?

Hospitals that aim to be carer-friendly must recognise carers as expert partners in care, not only in policy but in the way nurses, doctors and health care assistants engage with carers on the wards. Carers should be involved in conversations about treatment and support from the point of admission and consulted about discharge. Carers should be told how they can expect to be treated, and have access to the information they need.  There are also practical things that hospitals can do for carers to make life easier when they are spending long hours looking after a loved one in hospital – including free or discounted parking, flexible or extended visiting hours, access to a break room and discounted meals.

There are examples of good practice that we can learn from here – for example, Ipswich Hospital NHS Foundation Trust has introduced a ‘Family Carers Passport’. Passport holders are given a ‘Caring for Carers’ badge so that staff can see straight away that they are a carer. They have extended visiting hours and access to a kitchen which they can use to rest or wait while tests are done. Importantly, the Passport is also intended to encourage conversations between the carer and hospital staff – this commitment to working in partnership with carers is outlined in the document and contact numbers for further support are provided with it.

Another key element of a ‘carer-friendly NHS’ are primary care services that work for carers. Primary care has a crucial part to play in identifying carers, supporting their health and wellbeing, and making sure they know where to go for essential advice and information – something that does not happen often enough. Although the majority of full-time carers say they have a GP who knows of their caring responsibilities, of these carers almost three quarters say that their GP doesn’t do anything differently to accommodate them.

Carer-friendly primary care services means identifying and supporting carers. For example, as part of a Tri-Borough initiative in London, Carers UK is working with GP surgeries to identify a carer lead in each practice who, with support, encourages colleagues to be more carer-aware, increase the number of carers identified and refer these carers for support where appropriate. The initiative is still in its early stages but is already showing signs of success – which translates into practical help for carers with nearly 3 in 4 accepting the offer to be referred on to a local carer support service.

Approaches like these have the potential, over time, to change the culture of the NHS, so that it becomes second nature for health professionals to recognise and engage with carers on a day-to-day basis. With pressure on NHS services increasing and budgets being squeezed, we cannot afford to overlook the benefits that being more carer-friendly can bring – or the costs of ignoring carers’ expertise and failing to provide the information and support they need. Building a carer-friendly NHS should be a priority for all political parties, now and into the next Parliament.

i Carers UK’s State of Caring Survey 2013


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