Lord Darzi has been asked by the health secretary.to review the main challenges facing the NHS, including ensuring that care for people with long-term conditions is joined-up, patient focused, offers best value and is delivered with dignity in the best location for each patient, which for many will be their own homes.

Lord Darzi has been asked by the health secretary.to review the main challenges facing the NHS, including ensuring that care for people with long-term conditions is joined-up, patient focused, offers best value and is delivered with dignity in the best location for each patient, which for many will be their own homes.

These goals are unachievable without the NHS demonstrating its commitment to the New Deal for Carers outlined in the Our Health, Our Care, Our Say white paper..There are.6 million.carers in the UK and counting. The government acknowledges that the NHS would collapse without their unpaid contribution. Many are relied on by a sick, disabled or elderly relative 24 hours a day and some are only reached by our carers' centres after a decade or more of caring without a day off. Too often, clinicians ignore the knowledge and expertise about a patient's condition that comes from full-time caring for a loved one. Care plans are still being put in place that fail to consider whether the burden that will be placed on the carer will simply result in two sick people instead of one.

The NHS is consulting on its proposals for inspection of health services -.the draft health and social care outcomes and accountability framework. This bears little resemblance to the white paper. It.contains only two.suggested instances of 'support for carers' as indicators of good performance out of 103. It proposes that health services should be.inspected on whether they will provide social care services that are 'safe for users', but there is no mention of whether they will be safe for carers. If this framework remains unchanged, health-funded carer support services will be closing just as the ambitious national carers strategy is due to be launched.

The reality for many vulnerable patients is that 'patient control' requires listening to and respecting carers. The least carers deserve is to be treated with dignity too.

Alex Fox is assistant director of policy and service development at the Princess Royal Trust for Carers.

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