This blog post has been contributed by Will Davidson:
I’m Will Davidson, I have been volunteering with the Policy department at The Princess Royal Trust for Carers for the past two months, helping to research how government proposals will affect carers, especially on the issue of Carers Breaks.
Today we launched a report looking at whether Primary Care Trusts (PCTs) have been working with carers’ organisations to develop plans and budgets for carers breaks and if these plans have been published. Late last year the Coalition Government announced increased support for carers by allocating an additional £400m over 4 years to PCTs to focus on providing breaks for carers. They requested that each PCT works with local authorities and carers’ organisations to publish policies, plans and budgets to support carers.
So are PCTs following these guidelines set out by the Government? Do carers’ organisations feel more engaged now than they did before these announcements?
We found that only 9% of PCTs had developed updated plans and budgets for carers taking into account the additional money. 54% said that they would do so during 2011/12, and some very shortly. Carers will be disappointed that many PCTs are still developing plans eight months after the Government announcement and guidance. The remaining 37% said they would not be updating their plans.
For me, the most concerning finding is the number of PCTs still not working with carers’ organisations to develop plans and budgets. 82% of PCTs advised that they were working with carers’ organisations to develop plans and budgets, but carers’ organisations did not agree. 40% of PCTs were judged by carers’ organisations not to have engaged at all to develop plans and budgets.
Having minimal or irregular contact with carers’ organisations, or providing some funding for organisations connected to supporting carers does not in our view constitute real co-production of plans and budgets.
That said the examples in Sunderland and Richmond highlighted in previous blogs show that there is progress being made in some places, and we do think that more PCTs are now engaging with carers’ organisations and funding services than before. But the NHS as a whole has not made a breakthrough in supporting carers. PCTs must redouble their efforts, admittedly at a time of uncertainty for them, and Government must remember its’ responsibility and commitment to carers when considering its response to our findings.
You wait on one for ages, and then two come along. Not long after Sunderland PCT announced over £600,000 to support carers, NHS South West London and the London Borough of Richmond upon Thames have pledged £281,000 to give carers a break this year. Some of the projects funded will also provide counselling and debt advice projects, respite breaks for older carers and a mental health carers information project.
Unsurprisingly, there is a strong carers’ voice in Richmond with a Carers’ Forum that meets quarterly, an annual carers’ conference, a survey and a Carers’ Strategy Reference Group which brings together the council, the Primary Care Trust with charities such as Richmond Carers’ Centre and Crossroads Care Richmond. Caroline O’Neill of NHS South West London Richmond Borough Team was clear that working with local carers and carers’ organisations and influenced their decisions.
“We are committed to ensuring that carers are supported by both the health and social care services provided for them and those they care for. We are proud of our partnership approach working closely with local authority colleagues and local carer organisations to deliver for carers.”
This theme of local authorities and PCTs working with charities was also pinpointed by Melissa Wilks, CEO of Richmond Carers’ Centre:
“Strong local partnerships between Health, Social Care and the voluntary sector are vital to making a difference to carers lives. Richmond Carers Centre welcome this approach and the investment in short and long-term support for both adult and young carers.”
Both Sunderland and Richmond have strong local carers’ organisations and carers who are used to talking with local decision makers about the support that they need and how things can be improved. But there are some areas that do not have well-funded local charities doing this and there are some councils and PCTs that are not engaging with carers or carers’ organisations.
The Government’s idea of local communities being active in decision making is partly dependent on have strong local charities who are involved before decisions are made and finalised. Government has asked each PCT work with local carers’ organisations to develop plans and budgets, so we have been researching whether Richmond and Sunderland are the norm, or are just the exceptions.
We will be publishing our findings on Thursday 14th July and you can read about it here.
The Princess Royal Trust for Carers and Crossroads Care launched our campaign to Give Carers a Break in May and since then many Carers’ Centres and Crossroads Care schemes have been working hard with their local Primary Care Trust (PCT) to increase investment in support for carers. Primary Care Trusts and your local NHS, have been given £400m by Government to improve support for young and adult carers, but the money is not ring-fenced so can be spent on anything at all. We fear that many PCTs will choose to spend the money in areas other than supporting carers.
However, there are some PCTs who are showing that even in such tight financial times, increasing support should be a priority.
After working closely with Sunderland Carers, Sunderland Primary Care Trust are investing £630,000 this year for extra services to give carers the support they need and deserve. Penny Davison of Sunderland PCT explained that supporting carers was key to the care of people with disabilities and long-term illness when she said:
“We value and recognise the huge contribution carers make to caring for friends or relatives who may be disabled or seriously ill. We have seen the benefits that providing short breaks to carers can have on their health and wellbeing and are keen to ensure that carers can access a range of quality services that will support them in their caring role.”
Ailsa Martin, Chief Executive of Sunderland Carers’ Centre, has been instrumental in working with the PCT to put this plan together and believes more carers will get support earlier helping them to maintain their own wellbeing.
“We want to reach carers at any early stage, preventing unnecessary. This extra investment enables us to provide new services, including group breaks for isolated carers who may be didn’t take breaks previously because they had no one to go with.”
The NHS is facing tough times but Sunderland PCT has shown carers should be a priority. Using the money allocated to them by Government, they will help carers maintain their own health and that of the people they are caring for. The whole NHS needs to follow the lead of Sunderland PCT and Ailsa is right when she advises that “ Sunderland PCT and NHS South of Tyne and Wear should be applauded for their commitment to carers.”
Do leave comments about what is happening in your area, and whether there is something to applaud or something to be angry about. You can get involved in our Give Carers a Break campaign by sending letters to your MP or councillor asking them to make sure your PCT follows Sunderland’s lead.
Take care, and action (!)
Well, we finally reached an important landmark on Monday 26th July, with the publication of “Caring Together”, the new Carers Strategy for Scotland, and “Getting it Right for Young Carers” the UK’s first separate Young Carers’ Strategy.
As we move into one of the most difficult financial periods for decades the Scottish Government has allocated approximately £5.5 million to the Carers and Young Carers’ Strategies – and all of this will go to the voluntary sector. £5 million will be focused on developing and expanding innovative respite and short break services for unpaid carers and young carers.
The Princess Royal Trust for Carers has been directly involved in helping to shape the content and actions of both documents.
Key highlights include:
- Creating a Carers Rights Charter – the Government is also consulting on legislating for carers to have access to Direct Payments in their own right.
- Investing in carers training, building on an existing £281,000 investment during this financial year.
- Improving the identification of carers by health and social care services
- Making carers’ own health and wellbeing a priority
- Promoting carer-friendly employment practices and encouraging income maximisation
- In a Scottish and UK first, it includes a separate strategy on young carers – “Getting it Right for Young Carers”. This includes a range of actions which will help professionals from a range of agencies to better identify and support young carers to achieve their full potential.
- An investment of £150,000 to The Trust to develop a 4th Scottish Young Carers’ Festival in 2011, which will help review progress in implementing “Getting it Right for Young Carers”.
Carers and young carers in Scotland will directly benefit from the welcome additional investment in a range of ways, demonstrating the Minister for Public Health’s commitment to carer and young carers’ issues in Scotland.
As a carer going through our own crisis situation at home, I know how hard we will all need to work to ensure that both documents are fully implemented. Much still needs to be done, and the strategies are a brilliant starting point.
We retain some concerns about what happens now that the strategies have been published:
- The need to ensure that sustainable funding is in place for Carers’ Centres and young carers’ projects. They continue to experience a substantial increase in demand for support in their local areas, but in many cases, with no increase in funding to deal with this.
- The Concordat between local and national government which means that there is no compulsion on local authorities to implement the strategy documents.
- As we move toward unprecedented public sector cuts, the strategies make a clear case for investing in support for Scotland’s 657,000 carers and 100,000 young carers. However, the fact is that carers and young carers are still an easy target when cuts are being sought – recent developments at Westminster in relation to benefits and feedback from local areas in Scotland demonstrate this.
It is vital that an implementation plan is put in place as quickly as possible with all key players ‘signed up’ to take things forward. The Trust has a key role to play in this.
Carers’ Centres and carers can also use the documents at local level to hold councils, health boards, Community Health Partnerships and others accountable. How are they implementing the documents; what actions are they taking locally to improve carer support; what are local authorities doing with other partners to ensure that young carers have the chance to be children and young people first?
So, we are on the next stage of the journey – and we are under no illusion about the challenges which lie ahead in implementing both the vision and actions within each document. We would urge carers to speak to their local MSPs to ensure they are supporting and pressing for the strategies to be implemented. Meet with your local Councillors to ask how local authorities will take the strategies forward.
We will also be working with Carers’ Centres to ensure that decision makers are fully aware of the brilliant work that they do, how this benefits carers and what carers and young carers need to enjoy a quality life in their own right.
The Independent Budget Review report was published yesterday (29th July). Lead by Crawford Beveridge, it outlines that no part of public sector spending should be exempt from cuts. John Swinney has invited all political parties to look at the findings and the options for Scotland’s budget in future. Members of the public have been asked to contribute ideas about public spending. Please take some time to submit ideas and highlight the importance of maintaining funding for carer support.
See below for more information:
Note: This post is from our guest blogger Tony Baldry MP who is Co-Chair of the All Party Parliamentary Group for Carers. Tony Baldry MP made a speech at the meeting of The Princess Royal Trust for Carers held in the House of Commons on Wednesday, 28th July 2010.
Last week, the Prime Minister repeated his commitment to the Big Society making it clear that its’ success will depend “on the daily decisions of millions of people – on them giving their time, effort, even money, to causes around them”. My whole political life has been predated on this same principle.
However, I am concerned at a potential and unintended conflict between the Coalition Government’s very understandable desire on the one hand to promote the Big Society and the need to cut the budget deficit.
In my constituency in Banbury we have the North and West Oxfordshire Carers’ Centre, member of The Princess Royal Trust for Carers and has been successfully running now for nearly two decades.
Such has been the dedication and commitment of the volunteers that the centre has won the Queen’s Award – one of very few such awards in Oxfordshire. The Banbury Carers’ Centre like the Oxford and South Oxfordshire Carers’ Centres are comprised of a mixture of experienced volunteers and some paid staff, enjoying the financial support of the local community.
They help train carers. They provide outreach services for carers. They provide a place where carers and different types of carers can come and meet, share experiences, unwind and support each other.
As we all know, carers come in many kinds from young carers to very elderly spouses still looking after a much loved husband or wife.
In undertaking this valuable work, for many years the Banbury Carers’ Centre has received funds from Oxfordshire County Council to deliver specific agreed services to carers. The reasons the County Council was procuring these services from Carers’ Centres are exactly the reasons set out by the Prime Minister in support of “the Big Society”; Carers’ Centres and their volunteers are exactly the people who are making a difference, are in contact with other carers and are in the best position to understand, articulate and meet carers’ needs. They are full of people who come together and work together to affect social change and to improve life for carers.
As far as I am aware there has never been a suggestion that the Banbury Carers’ Centre or the other Oxfordshire carers’ centres have failed to meet the objectives with which they have agreed with the County Council. However, the Council has to make savings in their budget.
They are proposing withdrawing their funding from the carers’ centres in Oxfordshire and replacing that service by a telephone call centre, almost certainly run from outside of the county to which carers will be able to call.
Part of the justification of this move, in addition to the need to save money, is an assertion that it will help them reach more carers. However, there doesn’t appear to have been any or any real discussion with the existing Carers’ Centres as to the number of carers that they are already reaching.
I would suggest the issue here is that many people who are carers simply don’t recognise themselves as being carers and if they don’t recognise themselves as being carers, they are not likely to ring a carers’ telephone hotline.
We need a collective effort to help carers voluntarily register themselves as carers so that they are recognised as being carers by GPs or by schools if they are young carers. This requires a sustained campaign in GPs surgeries, in the schools, and in the media to make people ask the question “are you a carer?”
I suspect that for many years GPs haven’t been asking the question of whether someone is a carer, because there has been very little that they could do to support them. However, now that PCTs have funds to support respite care, GPs are in a position to refer carers for respite care and short holiday breaks and for that reason alone, one would hope that every GP practice would know which of their registered patients are also carers.
I think the reality is that for many years central government has used local government to support a whole range of social interventions. Money for carers’ breaks is given in part to PCTs and given in part to local Councils. However, if local government is obliged to save money, they understandably start by reducing funding for those organisations for which they have no immediate responsibility.
However, there are a very large number of active citizens undertaking constructive voluntary work within our community who to a certain extent depend on some funding from local government. An alternative, of course is to allow organisations such as the Banbury Carers’ Centre to bid direct to central government to provide carers’ services.
Here we appear to be bedevilled that Oxfordshire County Council has decided to bundle up all its carers’ contracts into a single contract, thus bringing it within the parameters of the EU procurement directives and requiring compulsory tendering. This makes it much more difficult for local voluntary organisations to bid and appears to run completely counter to the desire for localism and the Big Society.
I think we all have to accept that these are particularly difficult and unusual times. No peace time government has had to tackle a similar financial deficit. We need to develop the Big Society. We need to see how we can best reconcile these two policy objectives. However, to start with we have to recognise and acknowledge that there are some real tensions that need to be worked through.
Tony Baldry MP
House of Commons