A 10-Year Health Plan for England: what will it deliver for carers?

The Government’s new 10-year Plan for Health is an opportunity to set a new course for the NHS, and fundamentally reshape its services over the next decade.

The Plan is set out under three shifts in focus the Government wants to see: from hospital to community; analogue to digital; and treatment to prevention.

All three of these shifts aim to transform the way health is delivered across England, bringing services closer to the people accessing it, including carers.

Carers play a vital role in the day to day care of the people that they support. Centre for Care estimates that this care is worth £184 billion a year.

However, carers provide more than just monetary value; they also help to keep people well and out of hospital whilst on waiting lists, support safe discharges, and prevent readmissions.

Carers could therefore support the Government’s aspirations to cut waiting lists, improve outcomes, and deliver care closer to home.

But carers are not a free resource. They are people with their own needs, often juggling jobs, their health, and finances.

This means that, if the 10-year plan is to succeed, another shift is needed - from seeing carers just as partners, to seeing carers as people.

To do that, the NHS must support carers as individuals in their own right, and not simply as partners in care.

If carers are properly prioritised, the Government’s new 10 Year Plan could bring meaningful, lasting change for everyone involved in health and care, including the estimated 5 million carers in England.

The NHS Long Term Plan in 2019 made some progress towards this, acknowledging the impact that caring can have on a person’s health and wellbeing. It has also implemented some positive steps, including:

• The GP quality markers and ‘top tips’ to help identify and support carers, including young carers
• Work to improve emergency planning
• Greater access to social prescribing

These developments showed what is possible when carers are considered in national policy. But more must now be done to ensure that carers are supported as individuals.

Within the new Health Plan, Carers Trust is pleased to see a commitment to include carers in care planning and the production of care plans for individuals with complex needs.

Care Plans should take a Whole Family Approach and consider the support carers need as well as their ability and willingness to provide care. Local carer organisations are ideally placed to provide that support.

That’s because they are embedded within the community with an already established, trusted relationship with carers in the local area. We look forward to seeing what future implementation of this looks like for carers at a local level.

Carers Trust also welcomes the ambition to make services more accessible and based at the heart of the community.

The new Neighbourhood Health Service should be geared up to identify and support carers, alongside establishing relationships with local carer organisations.

Unpaid carers already provide vital care in communities across the country, and local carer organisations have always delivered multiple services under one roof.

Local carer organisations have shown the benefits of neighbourhood working for decades and are the centre of support for carers and their families.

We feel that the 10 Year Health Plan provides the platform to build on this and make this transformation happen.  

While the Health Plan sets out some potential benefits for carers, however, it also contains some risks.

We know that carers are already stepping in when people are unable to access good quality social care. Research shows over 2 million carers are providing  35 hours or more care per week, with 1.7 million of those caring for over 50 hours.

As health care moves closer to the community, there is a danger that carers will be expected to fill gaps around co-ordinating care and managing people’s health, without additional training, support or respite.

Plans to enhance the NHS App also provide risks and opportunities. If done well, many carers will welcome the chance to use the App to book appointments, view records and communicate with care teams.

However, some carers find digital technology challenging. It is vital therefore that guidance around information sharing and permissions are clear so as not to create extra barriers. Carers also need to be supported through this digital transformation.

What do carers need?

To turn ambition into action, carers and the organisations that support them need recognition, resources and leadership. Alongside the ambitions to transform the NHS over the next 10 years, health services need to increase their support for carers. This can be delivered through:

• A clear, Carers Plan that sets out how carers will be recognised, supported and empowered across every part of the health system. The plan needs to be co-produced with carers to ensure it meets their needs.
• A dedicated carers lead in every integrated care system with the authority and resources to implement change
• Suitable and sustainable funding for local carer organisations to ensure they are able to support carers to live full, connected lives alongside their caring role.

Health and Wellbeing Alliance

Through the Health and Wellbeing Alliance, Carers Trust is working closely with the Department of Health and Social Care and NHS England.

Together, we are exploring how organisations across the voluntary, community and social enterprise sector can engage meaningfully with the emerging priorities of the 10-year plan.

This includes ensuring carers' voices are heard in the design and delivery of health and care services, addressing health inequalities and ensuring that carers are supported and empowered as part of the NHS’ transformation.

The 10 Year Plan for Health could set the direction for a system that truly values unpaid carers, not just in strategy documents but in day-to-day practice.

But to get there, we need a shift in how the NHS thinks about carers. If we get it right, the system will work with, and for, carers, rather than simply relying on them.

Chloe Rollings is Policy and External Affairs Officer at Carers Trust. If you’d like any more information please email crollings@carers.org.