Anniversaries are always an opportunity to reflect on where we have come from, as well as think about where we are going. The NHS has seen a huge amount of change in 75 years, driven by developments in medicine, technology, society and the innovations of our staff and partners.
One of the constants throughout our history has been our essential partnership between the NHS and unpaid carers. It is estimated that the number of people providing care for friends and family members could be as high as 10.6 million.
Indeed, the economic value provided by carers has been shown to exceed the annual amount we invest in our health service. It is fitting, therefore, that we mark the 50th anniversary of the Carers Trust in the same year as the 75th birthday of the NHS.
Whilst the NHS and social care touch many people’s lives, often at the most critical moments, unpaid carers are there around the clock, helping to keep family members, friends or neighbours safe, well and independent. The NHS cannot afford to overlook unpaid carers, who often know patients best and can help prevent a condition from deteriorating or assist recovery after a stay in hospital. We therefore need to look out for carers’ needs too, as well as those of our patients. Not only do we rely on the work that carers do, day in and day out, but a third of those working for the NHS are also unpaid carers, demonstrating the need for us to be a conscientious and flexible employer.
As well as celebrating unpaid carers themselves, it is also important to recognise the vital work of the UK’s network of local carer organisations, who have a key role in helping us to join up health and care. Fifty years ago, Carers Trust was born after a TV soap broadcast a story about an unpaid carer, which led to the founding of the UK’s first local carer organisation. Half a century on, this is now a vibrant network of local organisations.
One of the key tests of integrated care is whether it supports unpaid carers to look after patients, rather than requiring the carer to join up services which don’t communicate effectively with each other. Many local carers organisations are helping us to do this by driving carer strategies and designing new care pathways with integrated care systems which now formally bring together health and social care services.
A hospital discharge project was set up in partnership with a local Healthwatch organisation in each of the NHS England regions. A minimum of 10 semi-structured in-depth interviews were held with carers with recent (last 6 months) experience of hospital discharge to pick our key themes.
Every healthwatch then used the carer experience/carer stories to hold a workshop with professionals from health, social care and the voluntary sector to highlight good practice and look for ways to improve carer experience.
Key learning points included asking the right ‘trigger’ questions at the earliest opportunity, including:
- sharing knowledge between services
- taking a person-centred approach with carers seen as equal partners
- the importance of staff: awareness/knowledge as their single point of contact
- the complexity of discharge arrangements across many teams/emotional impact on carers
- the carer voice needs to be heard in assessment of quality of discharge.
Since the COVID-19 pandemic, many more unpaid carers have been identified, by general practices, local authorities, schools and carer organisations. This gives us a great opportunity to give carers better access to information and advice at an earlier stage. It is also important to acknowledge that unpaid carers, just like NHS staff, have been under increased pressure since the beginning of the pandemic, which means we need to ensure that carers’ own needs are considered as a key component of population health management.
Caring for others is something most of us will do in our lifetimes. Whilst the experience of caring varies for everyone, most of us will rely, at some point, on the essential partnership between the NHS and unpaid carers. We’ve worked at strengthening the foundations, but we need to continue to make this a partnership that works for everyone.
This is why, on its 75th birthday, the NHS Assembly identified unpaid carers as core to our ambitions for the future. If we are to deliver truly transformational change for patients, we can only do that by recognising and supporting unpaid carers and making sure that they are built into all of our plans.