Invisible link

Prime minister Tony Blair announced the first national strategy for carers last week. The move followed hard on the heels of a report which accuses the NHS of glaring omissions in the support it gives carers.

The strategy will follow a government-wide review of measures to help carers, led by junior health minister Paul Boateng, who acknowledged that support for Britain's 6 million carers is patchy, with some getting 'next to no help at all'.

The plan is that initiatives already in the pipeline (such as a charter for people in long-term care) will be pulled together, new ideas generated, and an independent group set up to advise ministers and policy-makers.

The report Ignored and Invisible? Carers' experience of the NHS suggests that health service managers and clinical staff are certainly in need of a prompt from central government. Based on a survey commissioned by the Carers' National Association, the report aims to present (despite its polite questionmark) an open-and-shut case.

Just under half the 3,031 carers who responded had been told by NHS staff about the type of care their loved one might need after discharge from hospital. But one in three felt their comments and concerns had not been taken into account by staff arranging the discharge, and almost three- quarters were not given a copy of the agreed care plan.

Almost 90 per cent of carers were given no advice or training by NHS staff on lifting and handling. Not surprisingly, more than half had been injured (typically a back injury) or succumbed to a stress related illness. GPs were identified as the best source of support and help in the NHS - yet only 14 per cent of carers said their GP ever visited to see how they were managing.

At the launch of the report, NHS chief executive Alan Langlands conceded that the NHS's response to the Carers Act 1995, which gave carers the right to an assessment of their ability to care, has been disappointing. 'I do feel slightly uneasy that we haven't been able to embed the principles of the Carers Act into the daily routine of the NHS.' But he refused to criticise managers or professional staff, and defended the government's record.

The NHS Confederation, while conceding that the report gives 'useful pointers to help the NHS help carers', clearly does not feel that health managers should be hanging their heads in shame.

Special projects manager Chris Vellenoweth says there are 'difficulties' with the report: it makes no attempt to measure levels of support the NHS should provide, and (as a survey by the CNA of CNA members) is hardly independent. 'Things are not quite as bad as the report paints. About 70 per cent of carers were consulted about discharge plans.'

Melanie Henwood, the independent health and social care analyst who wrote the report, insists that the point was not to bash managers, but to help them see that carers should be an integral part of the agenda, not an optional extra.'If change doesn't come from managers, then it's not going to come at all.'

Ignored and Invisible? Carers' experience of the NHS. Available from CNA, 20/25 Glasshouse Yard, London EC1A 4JS. pounds10.