Background

• More than 6 million people in the UK are carers, 1.3m caring 50+ hours per week.
  
• 2 million people move in and out of caring each year and 1 in 8 people are carers.
  
• 175,000 of the six million carers are children, often missing out on school and childhoods in order to care.
  
• 60% carers leave the workforce due to caring responsibilities; on average, carers retire 8 years early.
  
• The main carer's benefit is £48.65 for a minimum of 35 hours, equivalent to £1.39 per hour.
  
• If every Carer stopped caring it would cost the government £87 billion a year.
  
• 80% of carers say their health suffers from caring
  

Introduction

The Prime Minister's preface says that the strategy is the "start of a process rather than the end", that the strategy "acknowledges that carers need more help and support than has been available in the past" and "above all we recognise the need - repeated so many times throughout our consultation - for better support for respite and short breaks."

The forward is signed by seven Secretaries of State (DH, CLG, DWP, DBERR, DCSF, DIUS, Gov Equalities Office). It says that "every day 6,000 people take on new caring responsibilities" and that "people who provide a lot of care tend to have lower incomes, poorer health, and are less likely to be in work than their counterparts."

Good practice from The Princess Royal Trust for Carers and Crossroads Caring for Carers is mentioned on numerous occasions. Our joint media response is on www.carers.org and www.crossroads.org.uk.

We feel the strategy is a very positive document, with a range of useful commitments backed up by useful resources. It is strong on commitments from DH, including the NHS as well as social care, and from DSCF on young carers. It is weaker on groups currently under-supported, with carers from BME communities, carers of people with substance misuse and mental health problems, and LGBT carers mentioned but mainly covered via good practice examples. There are no commitments on carers' rights, such as the right to protection from discrimination by association, despite the current case before the European Court which is likely to establish that right in employment law. There could be more on the need for outreach services to ensure carers get into the system. The strategy does not go so far as to attempt a new, shared understanding of the "caring contract" between family and state, which is a key issue for the current review of adult care and support.

With carers services in some areas facing cuts and lack of sign up from councils or NHS trusts, there is a huge amount of work to be done by government working with the third sector, to make the strategy's aspirations a reality.

New pan-government definition of carers

The Vision

"By 2018:

• carers will be respected as expert care partners and will have access to the integrated and personalised services they need to support them in their caring role;
  
• carers will be able to have a life of their own alongside their caring role;
  
• carers will be supported so that they are not forced into financial hardship by their caring role;
  
• carers will be supported to stay mentally and physically well and treated with dignity;
  
• children and young people will be protected from inappropriate caring and have the support they need to learn, develop and thrive, to enjoy positive childhoods and to achieve against all the Every Child Matters outcomes." (p9 and p16)

The Executive Summary says: "The needs of carers must, over the next 10 years, be elevated to the centre of family policy and receive the recognition and status they deserve." The strategy should be viewed alongside the Independent Living Strategy, the social care reform programme set out in Putting People First, the long-term reform of the care and support system, NHS reforms, reforms within children's services and welfare reform.

Existing commitments

New commitments, 2008-11

• Providing every carer with comprehensive information through support to local services.
  
• £150m to PCTs for flexible breaks, meeting the needs of both carers and the people they support.
  
• Pilots (£4m) will help to develop new models of break provision and demonstrate cost-effectiveness.
  
• Pilots for more joined-up service provision between the NHS, local authorities and the third sector.
  
• Pilots to improve the support offered by GPs for carers and pilot annual health checks for carers.
  
• Up to £38m to enable carers to combine paid employment and caring role/ re-enter the job market.
  
• Improving the emotional support offered by central, local government and the third sector to carers.
  
• Training to strengthen and empower carers in their caring role.
  
• Training professionals across the board, from health to housing, to provide better services and support.
  
• Ensure that third sector support for carers is available throughout the country to a larger proportion of carers.
  
• Provide vital data about carers to aid local and national commissioners and policy makers.
  
• Establishing a standard definition of carers across government.

There is £6m to ensure young carers are protected from inappropriate caring and receive support:

• strengthening support from universal services through training and resources for schools etc
  
• £1m for projects "focused on lifting young carers out of excessive caring".
  
• strengthening the quality and join-up of support around families so children are better protected from inappropriate caring, through £4m to add to the £3m already committed via the Family Pathfinder pilots
  

The longer term, 2011-18

• Carers able to access specialist carers' services in every community.
  
• consider the need for a lead professional for carers.
  
• Review benefits available to carers in the context of benefit reform and the review of care and support.
  
• Consider further increases to break provision taking account of evidence about quality and outcomes.
  
• Disseminate models of best practice  from various pilots announced in the strategy.
  
• Consider providing replacement care for carers to attend hospital appointments and screenings;
  
• Review legislation around information sharing, especially in cases where mental capacity is an issue.
  
• Review the national indicator set to ensure that carers' experience of services is measured.
  
• Develop relationship between local authorities, the third sector and carer-led organisations and examine how best to utilise the Carers Grant to the benefit of carers.
  
• Consider allowing payment of carers via Direct Payments. Legislation is already underway to extend the availability of direct payments to people who lack mental capacity, which will allow more carers to receive payments on behalf of relatives, including parents of severely disabled children who currently lose their entitlements when they turn 18.
  

Income and employment

Expectations were raised during the strategy consultation that benefits will be raised, but there will be no immediate help to the 460,000 carers currently subsisting on Carers Allowance (around £50 p week). Carers will be adversely affected by the 10p tax changes and by rising fuel, heating and food bills. Carers often transport the person they care for to daily health appointments and they often need to keep a disabled or elderly person warm in poor housing conditions.

The strategy stresses the need to combine paid employment and caring roles. This will be achieved "through the provision of better services for the person being supported, increased break provision, easier access to training and skills and encouraging more flexible working opportunities" (p85). Extending rights to make flexible working requests to the 20% carers who are not co-resident and/or relatives will be considered. Care partnership managers will be introduced at JobCentre Plus (JCP) branches alongside training for JCP staff, marking vacancies as "carer friendly", funding replacement care for carers on approved training courses and investigating providing Sector return to work support via the Third Sector. A good practice guide for all employers on the benefits of employing carers will be produced. Flexible learning opportunities will be promoted. There are likely to be new opportunities for carers' services to work with JCP and learning providers arising from these commitments. All of these developments are positive for the work of local carers services, who have proved capable of keeping carers in employment where JCP and other partners can be engaged.

Health

Implementation and monitoring

The Princess Royal Trust for Carers and Crossroads Caring for Carers

Crossroads - Caring for Carers is about giving time - improving the lives of carers by giving them time to be themselves and have a break from their caring responsibilities. Our aim is to provide a reliable service, tailored to meet the individual needs of each carer and the person they are caring for. We have schemes in most parts of England and Wales, which provide a range of services to meet local needs. Over 4.6 million care hours are provided every year to more than 35,000 carers - the equivalent of over 525 years of care.  www.crossroads.org.uk

Contact details for policy issues:

Copies of the Strategy from

Disclaimer:

Author: Alex Fox, The Princess Royal Trust for Carers Updated 6/15/2008