Carers – it’s time for a culture change

Since the publication of this blog Dr Martin McShane has left NHS England.

As NHS England’s chief executive Simon Stevens today paid tribute to carers for their “immense contribution” and pledged to do more to help them, Dr Martin McShane acknowledges the vital role they play:

I remember being put aback when interviewed for medical school by the apparent scorn, from my interviewers, to my proposition that I wanted to do medicine because I wanted to care for people.

On reflection I suspect it was the fact that they did not see this as a unique attribute to medicine and I know they were right.

Over the years I have seen care delivered by many professions but even more by non-professionals, people who have delivered a standard of care that has humbled me as a doctor: mothers and fathers looking after their severely disabled son or daughter, or daughters and sons looking after a parent with dementia; partners coping with a loved one with severe mental problems.

The success of our healthcare has been that people are living with problems that once would have been fatal and although the majority of us will experience a healthy and active old age, for some old age is plagued with conditions that requires support and continuing care. The NHS needs to acknowledge and value the contribution and potential of carers. That is why we have today published our commitment to carers.

I was trained to make the patient my prime concern. That remains appropriate and essential. Yet professionals also need to support and realise the potential of carers.

What we have heard, especially from people with enduring conditions, is that they need to be listened to and their carers valued. They live with their conditions 24 hours a day and, often, their carers share their lives 365 days a year. Professionals are allowed the privilege of entering their lives, intermittently.

Our commitment to carers is intended to start cultural change, one that will result in the importance of carers being constantly appreciated and their contribution to enhancing the quality of life for people with long term conditions properly valued.

I can put it no better than by repeating what we have heard the people we serve want us to deliver:

My care is planned with people who work together to understand me and my carer(s), put me in control, co-ordinate and deliver services to achieve my best outcomes.

Our commitment to carers is intended to take us further along our journey to making this a reality.

Dr Martin McShane was previously National Clinical Director for Long Term Conditions, since the publication of these blogs he has left NHS England.


  1. Bernd Sass says:

    Delivering for carers is just one example of bridging the gap between the good things that people are doing already, eg in supporting each other, and the large inability of the statutory sector to tie in commissioning resources with these assets and drivers of self-directed support.

    How can the system be pulled to spread and upscale those good things that kick in way before and beyond what traditional ‘services’ do? Patient-led commissioning? There are some small initiatives to support people to pool their personal budgets, use that collective insight to inform de- and re-commissioning and provide peer support as integrated element of commissioned care pathways. Can NHS E paly a role in nurturing such initiatives?

  2. Carol Munt says:

    Publishing a commitment is one thing, delivering it is the important part.

    • Sachdev Seyan says:

      I agree with Carol Munt’s response ‘Publishing a commitment is one thing, delivering it is the important part’. My experience is that clinicians and even those being trained in provision of statutory care only focus care for the service users but not for the unpaid carers who work 24/7 to provide care for their loved ones. Can someone provide me with links what is directly available for carers over and above their right to access a carer assessment.