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60,000 miles and 31 Mental Health Trusts later…..

I have been the Mental Health Policy Manager for England at Carers Trust for six years and three months (nearly). In my first month of the job, the Triangle of Care landed on my desk and as they say the rest was history. Now, all this time later as I prepare to leave Carers Trust I ponder: where are we now? What difference has it made?

If you still haven’t heard of the Triangle of Care (where have you been) it’s a resource that was developed by Alan Worthington and a group of carers based on their experiences of mental health inpatient services. It set out six key standards which, if in place, they would feel included and supported.


This short document originally written to improve carers’ experience of inpatient mental health services is now being implemented across all mental health services, learning disabilities, community health, substance misuse and older people’s services and is changing the culture of health as we know it.

I’m sure when it was written they never thought it would have been adapted for Scotland, Jersey and Australia and have reached as far as Japan and New Zealand.

Triangle of Care – beyond a project

When I first began working on the Triangle of Care, I thought (naively I realise now): “well this will take a couple of years but that’s all”. Six years on and although we have made huge strides I realise that I’m still only in the first half of the marathon race.

So what has this six years taught me? Well, firstly that that Triangle of Care goes beyond a project and is actually a programme for cultural change; health services are not carer inclusive, carers just aren’t part of core business (no matter how many Carers Strategies they write); Triangle of Care is changing that.

There is a will from many staff to include and support carers but this needs nurturing, support, training and empowering; this needs ongoing support from senior managers to see that including carers isn’t a quick fix but an ongoing process.

That there is huge amounts of good work going on out there and if one ward or community team can do it so can all of them! That you can get a lot done on not much money as long as you’re tenacious and determined, but it does need resourcing and it does need support.

We (Carers Trust) have achieved huge amounts on a tiny budget in six years, I often wonder what we could have done with the budget for Dementia Friends…….(sorry drifted off into a reverie there).

Adapting the Triangle of Care for multiple audiences

Now here we are six years on, we’ve adapted the Triangle of Care for dementia, for young carers and in the New Year will be adapting it especially for Children and Adolescent Mental Health services.

We’ve developed resources, guides, toolkits and given innumerable presentations as well as travelled on more trains over the entire country than I can count.

The next steps are exciting though, a new person and a fresh set of eyes will keep pushing Triangle of Care forward. I hope carers, service users and professionals will keep pushing for Triangle of Care in their services too. We’ve got 31 Trusts in England signed up (that’s more than half) but there are still some not signed up, not even involved.

You can check if yours is on our Carers Trust Professionals website, if they are get involved and support the implementation. If they’re not involved start asking why, write to the CEO and the Chair, and spread the word about Triangle of Care to other carers so that at every meeting and interaction someone mentions it.

Six years and 31 trusts have shown me there really is no excuse not to sign up to Triangle of Care; I’m proud of the legacy I leave behind and look forward to next part of the journey. The decision to leave was an incredibly tough one, but I know that Carers Trust will continue to drive Triangle of Care forward and how the NHS works with carers will change irrevocably.

You never know if you’ve done a good job or made a difference but this comment from the wonderful Veronica Kamerling shows the power of Triangle of Care:

“What you have done to put together and promote the “Triangle of Care” is so fantastic and incredibly inspirational. I hear it being talked about everywhere I go – it is a real success story and such a wonderful tool for carers and has got everyone thinking about carers!”


Blog by Ruth Hannan, Mental Health Policy Manager for England at Carers Trust

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December 14, 2016 Posted by | Mental Health, Triangle of Care | 2 Comments