Carers Trust Wales welcomes the opportunity to respond to the Environment and Sustainability Committee’s consultation on the general principles of the Well-being of Future Generations (Wales) Bill. Carers Trust is a new charity which was formed by the merger of The Princess Royal Trust for Carers and Crossroads Care in April 2012.
Carers Trust Wales works across Wales to improve support, services and recognition for anyone living with the challenges of caring, unpaid, for a family member or friend who is ill, frail, disabled or has mental health or addiction problems. With our Network Partners, local service providers across Wales, we aim to ensure that information, advice and practical support are available to all carers.
Our strategic aims are to
Together with our Network Partners, we provide access to desperately-needed breaks, information and advice, education, training and employment opportunities. Our Network Partners benefit from the provision of grants, advice documents and reports to improve carers' services. We give carers and young carers avenues to speak to someone and make their voices heard, offline via our carers' services and young carers' schemes and online via our interactive websites.
Our vision is a world where the role and contribution of unpaid carers is recognised and they have access to the quality support and services they need to live their own lives.
We provide support, information, advice and services for the millions of people caring at home for a family member or friend. Our Network Partners reach carers of all ages and with a range of responsibilities, in their local communities. From helping carers to access local services, to making their views heard by opinion formers and professionals, together we help carers to connect with everyone and everything that can make a difference to their lives.
With carers’ needs, choices and voices at the heart of everything we do, we strive to ensure that the enormous contribution they make to society and to those they care for is fully recognised, appreciated and valued.
1. Carers provide valuable unpaid care across Wales. Enabling carers to maintain their own well-being and the well-being of those they care through carer-focused services is essential in promoting a healthier, more equal Wales.
2. We broadly support the principles and aims of the Well-being of Future Generations (Wales) Bill, including providing a statutory underpinning for Public Service Boards, national well-being goals and local well-being plans.
3. A range of evidence demonstrates that carer-focused services, carer involvement and effective health-led strategic planning for carers improves outcomes not only for carers, but also for professionals and those that they care for.
4. As such, we have concerns regarding the impact that the Bill in its current form would have upon strategic planning for carers. Especially given the Bill repeals a key amendment to the Social Services and Well-being Act 2014 that sought to secure Local Health Boards as key partners in strategic planning for carers. We ask that the Well-being of Future Generations (Wales) Bill maintains Local Health Boards and NHS Trusts as the lead organisations for carers and protects their current responsibility to strategically plan how to meet the needs of carers.
5. Similarly, given the relevance that planning for carers and investment in carer-focused services has for a range of well-being goals outlined in the Bill and to the sustainable development principle, we would hope to see a greater level of detail on how the Bill relates to carers and carer-focused services on the face of the Bill and in subsequent guidance. Currently the only reference to carers on the face of the Bill requires Public Service Boards to take into account local authorities’ assessment of carers needs – we believe that to promote a healthier, more equal Wales there must be a stronger commitment to carer-focused services and strategic planning for carers, including how to meet need not just assess need.
6. Carers Trust Wales would welcome the opportunity to expand upon this response in an oral evidence session with the Environment and Sustainability Committee.
1.1 There are 370,000 unpaid carers
providing care to friends and families in Wales. The value of the
contribution that these unpaid carers make to Wales annually is
estimated to be £7billion[1].
1.2 The Well-being of Future
Generations (Wales) Bill aims to ensure that the governance
arrangements of public bodies for improving the well-being of Wales
take the needs of future generations into account. We broadly
support this aim. We also support a move to coordinated planning of
public services through public service boards using local
well-being plans.
1.3 We have concerns that a lack of
specificity around well-being goals and objectives will see areas
including the provision of carer-focused services and support for
carers sidelined in local well-being plans, particularly given the
constrained funding environment in Wales. Carer-focused services
play a key role in promoting a healthier and more equal Wales
– both described as key well-being goals by the Bill. Carers
receive only one reference on the face of the Bill – in
section 36 in relation to assessments of local well-being.
1.4 This is particularly concerning
given that, in relation to the sustainability principle,
carer-focused services adheres to a number of key points including
the deployment of resources in a preventative fashion (8,
(2), (d)) and the requirement to operate in a way that safeguards
the ability to meet long-term needs (8, (2), (b)).
1.5 The strategic planning of and
investment in carer-focused services has a long-term preventative
impact on public services. Evidence demonstrates that carer-focused
services contribute to reducing the amount of time spent in
hospital by people with long-term health conditions and avoiding
delays in the transfer of care[2][3][4].
Similarly, investment in carer-focused services conforms to the
Bill’s intended aim of operating under the sustainable
development principle – ‘to ensure that the needs of
the present are met without compromising the ability of future
generations to meet their own needs’. For example, we know
that commissioning breaks and emotional support for carers can
reduce overall spending on care and their need to access mental
health services[5].
1.6 Giving public service boards a
statutory underpinning may help alleviate current disparities
between local service boards. However, for them to be fully
effective they must be inclusive of the third sector and
non-government organisations that provide key ‘public’
services throughout Wales.
1.7 There are a number of Carers
Trust Network Partners throughout Wales that provide vital services
ranging from information, advice and support to domiciliary and
replacement care. We feel that these services provide key support
in helping the delivery of joined-up services. One such example is
through the promotion of the unique ‘Triangle of Care’
model[6]
that seeks to embed a tripartite approach to patient care that
fully involves in the carer – research suggests that such a
model improves outcomes and sustains wellbeing.
1.8 As such, we recognise and
support the inclusion of bodies representing voluntary
organisations as potential invitees of public service boards.
However, for the approach of public service boards in Wales to be
truly effective in improving the wellbeing of carers and those that
they care for across Wales, it is essential that productive ways
are found to fully engage with the breadth of organisations
operating in health and social care locally including dedicated
carer-focused services.
1.9 We support in principle the
introduction of assessments of local well-being and subsequent
local well-being plans. We are glad that the Bill requires that, in
preparing their assessments, public service boards will have to
take into consideration the most recent assessment carried out by
the local authority in conjunction with a Local Health Board in
assessing the needs for care and support, support for carers and
preventative services. However, we must stress that assessment of
need is only a piece of the approach required to effectively
support carers and, in doing so, move towards a healthier and more
equal Wales.
1.10
It is essential that
plans and strategies also take into account how to meet
those needs. Since the Carers Strategies (Wales) Measure 2010 came
into force, local health boards and local authorities in Wales have
been required to have Carers strategies that focus on the provision
of information and guidance for carers and support constructive
engagement with carers in decision making about the provision of
services for them and the person(s) for whom they care. What was
particularly noteworthy about the Carers Strategies (Wales) measure
was that it positioned local health boards as the strategic lead
for carers. This is vital as evidence shows that four out of five
carers first contact with a statutory agency is with a community
based health service[7].
1.11
Despite the Carers
Strategies (Wales) measure being repealed by the Social Services
and Wellbeing Act 2014, an amendment to the Act in Section 14
placed a requirement on Local Health Boards to submit any part of
their strategy that related to the health and well-being of carers
to Welsh Ministers. Yet the Well-being of Future Generations
(Wales) Bill as it currently stands would repeal that amendment. We
are deeply concerned about not only the loss of carers strategies
underpinned by statute, but also that the emphasis on local health
boards’ ownership of carers strategies will be lost.
1.12 We ask that the Well-being of Future Generations (Wales) Bill maintains Local Health Boards and NHS Trusts as the lead organisations for carers and protects their current responsibility to strategically plan how to meet the needs of carers and appropriately highlights the importance and preventative nature of investment in carer-focused services.
Kieron Rees
Policy and Public Affairs Manager, Carers Trust
07824567813
04-09-2014
[2] Williams, E, Fitton, F (1991) Survey of carers of elderly patients discharged from hospital. British Journal of General Practice, 41, 105 –108.
[3] Conochie, G (2011) Supporting Carers: The Case for Change; London: The Princess Royal Trust for Carers and Crossroads Care.
[4] Bebbington, A, Darton, A, Netten, A (2001) Care Homes for Older People: Volume 2. Admissions, Needs and Outcomes; University of Kent: Personal Social Services Research Unit
[5] Conochie, G (2011) Supporting Carers: The Case for Change; London: The Princess Royal Trust for Carers and Crossroads Care.
[7] Carers Strategies (Wales) Measure 2011 - Guidance to Local Health Board, NHS trusts and Local Authorities