Carers remain concerned over continuity and knowledge in the new NHS

Doctor checking blood pressureThe latest contribution for our blog series Lost in Transition? How carers’ services are navigating the new NHS is from the CEO of a large Carers Centre in the south of England. In it they reflect on the impact of recent restructuring on NHS staff and how changes are resulting in a lack of continuity and knowledge about carers’ issues...

The new NHS has arrived and in many respects this month’s NHS feels no different to last month’s. For carers, the impact of the most significant NHS changes since 1948 could take many months, or even years, to become apparent.

But for those of us working with the NHS—as commissioners of our services and as partners in the delivery of support for Carers—the changes are already apparent.

The first appearance of change was in the response of NHS colleagues. Staff working in and with the NHS are used to change. For some careers are measured not in years or promotions, but in restructures and cycles of change. A hardy few wear the number they have survived as a badge of honour, but even they have been going around in recent months with a dazed look that says “no, this one really is different”.

The second appearance of change has been in the sudden rush of business that absolutely had to be concluded by the end of March. Staff who have been in limbo for months getting to grips with new briefs, partnerships and responsibilities in weeks. If only it had been the other way round: weeks of uncertainty followed by months in new jobs with adequate time to prepare. And any number of contracts, policies and strategies to be reviewed, cancelled, revised, updated, or if all else fails extended on the grounds that ‘business as usual’ will do for now.

For us, at least until recently, most business to do with carers has fallen into this last category—neither big enough (in monetary terms) nor important enough (in commissioning terms) to appear on the CCG radar. But this continuity is only temporary; the sudden rush of business has been accompanied by a massive loss of history and knowledge as staff have moved on to new roles or pastures and this presents us with our greatest threat.

Whilst review of all services is inevitable, the loss of continuity sees this being led by commissioners who start with little understanding to inform their thinking.

Commissioners with little experience of carers needs and strategies, reviewing services they have not encountered before, alongside carers and providers who are strangers to them if not to each other. Some will tread carefully, take a long-term view, and ensure change does not create discontinuity and fear amongst carers and providers.

But some will not and therein lies the third, and thus far most worrying, appearance of change: an emergent tendency to engage in what could generously be described as “action research” but feels more like ‘changing stuff to see what happens’.

Add in to the mix all the usual jockeying, that inevitably accompanies change and competition for funding and position, and it leaves many wondering what the next few months will really bring.

Lost in Transition? bloggers are Chief Executives of independent carers’ organisations, who are providing insights into how NHS reforms are impacting on carers’ services and carers across the country.

Watch this space for more updates about what the changes to the NHS really mean…

June 24, 2013 Posted by | Lost in translation? | , , , | 1 Comment