Darzi unveils draft NHS Constitution

The draft NHS Constitution has been published today for consultation alongside a 10 year plan for the NHS.

For the first time in a key NHS document, the Constitution gives carers prominence as partners in care. We welcome this as the beginning of a culture change in the NHS towards valuing the extraordinary caring contribution of ordinary people. It builds on the NHS commitments to carers, including £150m new money for health trusts, set out earlier this month in the new ten year National Carers Strategy.

The Constitution begins with seven key principles to “guide the NHS in all it does”. Principle Four is:

“NHS services must reflect the needs and preferences of patients, their families and their carers. Patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment.”

The Constitution also makes the pledge: “The NHS will strive to work in partnership with you, your family and carers.” The 10 year plan states that: “Increased control will not be limited to those being cared for, but will also extend to carers.”

Recognition of unpaid carers as vital partners in care will require a huge cultural shift within the NHS, so the draft Constitution is only the beginning of a challenging process. The constitution continues the direction of travel towards local decision making in the NHS, so it will be important that the emphasis on carers is not lost at local level in areas where health trusts have not in the past recognised the value of carers. There is currently a huge disparity in levels of funding for carers services by health trusts in England, with some spending nothing on carers support.

The issue of confidentiality and data protection has been a stumbling block for carer involvement in the past, with carers often feeling that some NHS staff hide behind confidentiality as a reason for not properly engaging with the information needs of carers, despite those carers often having a 24/ 7 involvement in the care of their relative. So there is a tension urgently needing to be resolved through more detailed guidance between these two responsibilities given to all NHS staff:

You have a duty to protect the confidentiality of personal information that you hold.
You should strive to involve patients, their families and carers in the services you provide.

The Princess Royal Trust for Carers and Royal College of Psychiatrists, in their partnership, Partners in Care, produced some valuable resources on information sharing and confidentiality which we would like to see more widely adopted: www.partnersincare.co.uk

We encourage carers and carers’ organisations to raise these issues in responding to the consultation which can be found at: www.dh.gov.uk/consultations