By Bill Heaney
Unpaid carers are struggling to look after family members and friends and relatives who require their services when no care homes, hospital places or other solutions are available for them.
The findings in a new report from Carers Scotland paint a stark picture of carers buckling under the strain of propping up a health and social care system that is under severe pressure.
This pressure in the delivery of public sector services has meant that carers have been left to carry a growing burden of significant care – where social care cannot provide a service, it is unpaid carers who are expected to step in, where the NHS needs a “bed” it is carers who are left to support discharge.
At the same time, carers physical and mental health continues to deteriorate, often significantly whilst they have little time, money or energy to be able to maintain their own health and well-being.
Rightly, the Scottish Government has recognised the need to bring down NHS waiting lists and improve access to health services, including crucial mental health services.
However, they maintain that dedicated funding and planning is urgently needed to ensure that carers can access the health services they need and support for caring from social care services to prevent the shocking levels of poor health they are experiencing.
Scottish Labour health spokesperson Jackie Baillie said: “This landmark report lays bare the shocking state of the care sector in SNP Scotland. The findings are utterly harrowing – too many unpaid carers feel unsupported and are at their wits’ end, resulting in serious physical and mental health consequences, whilst staff feel undervalued and unprotected.
“Unpaid carers really are unsung heroes, but they have been badly let down by this SNP Government that is presiding over worrying levels of unmet need and a care sector workforce crisis.
“That’s why Scottish Labour will continue to fight for proper reform of the care sector in the interests of unpaid carers, staff and service users – including a commitment to provide access to a minimum of two weeks respite care, and a clear path to £15 an hour for care workers.”
Recommendations
To ensure all carers get the support they need to look after their own health:
1. The Scottish Government should develop and introduce a Carers Health Plan, recognising that unpaid care is a social determinant of health, and setting out how they will in the short, medium and long term not only maintain and improve the health of unpaid carers and young carers but prevent long term health inequalities.
2. Support for mental health is of significant concern and the Scottish Government should fund dedicated, tailored mental health support for unpaid carers, including providing funding to local carers centres, disability and condition specific organisations and palliative care organisations to enable them to commission mental health support for those they support. This should include support for anticipatory grief, bereavement counselling and specific mental health support for young carers.
State of Caring 2023: A health and social care crisis for unpaid carers in Scotland
3. The Scottish Government should fast track unpaid carers to support to maintain their health whilst caring. This could include: introducing direct payments or vouchers for carers to spot purchase non-NHS assessments, physiotherapy, counselling and other such services. Carers should have access to occupational support in the same way as health and care employees.
4. To ensure that carers are able to look after their own health, the Scottish Government should progress at pace actions within the National Carers Strategy to deliver flexible health appointments for carers, including providing replacement care for appointments.
5. Local health and social care partnerships and NHS Boards should develop their own local plans to deliver regular health checks for unpaid carers to identify health concerns or pre-conditions, such as high blood pressure and diabetes.
6. Local councils should seek to develop concessionary or free access to leisure services within their areas not just to carers in receipt of Carer’s Allowance but expanding to include all carers and young carers. This could include working with local carers centres and GP practices to develop social prescribing of leisure access.
7. The Scottish Government should work with NHS Boards to ensure their plans for reducing waiting lists set out how they will consider the unique and individual needs of unpaid carers, including prioritising carers for healthcare support that will support their ability to care.
8. Prior to the introduction of a right to a break from caring in the National Care Service, the Scottish Government should commit to:
• increase funding year-on-year for short breaks delivered by the voluntary sector,
including through the:
o Time to Live fund administered by Shared Care Scotland and local carers services.
o Take a Break Scotland fund for families with disabled children and young people
administered by Family Fund.
• increase funding year-on-year to health and social care partnerships and local
councils for a range of breaks from caring and ensure that this funding is protected
within their budgets.
• work to expand availability of short breaks services across Scotland to ensure that
when the right to a break is introduced, there are sufficient and varied services for
carers to choose from.
9. The Scottish Government should work with local councils, health and social care partnerships and NHS Boards to improve knowledge of carers rights amongst staff who come into contact with them and ensuring that carers can access support when it is needed by:
• improving access to Adult Carer Support Plans, in particular ensuring that they are
offered as standard to all carers during the hospital discharge process.
• improving referral routes between services for Adult Carer Support Plans and Young
Carer Statements to ensure that carers and young carers are able to have access an
assessment and services promptly.
• encouraging greater and more consistent use of flexibility within self-directed
support to empower and better support unpaid carers and those they care for. This
should include simplifying administration, promoting the ability to employ close
relatives and considering enabling unspent budgets, (which cannot be spent due to
lack of services) on other costs that support well-being.
• improving uptake of emergency planning (and anticipatory planning) within both
Adult Carer Support Plans/Young Carer Statements and in care planning.
10. To improve both the visibility and value of care, the Scottish Government should introduce add a new dedicated national outcome on care to fully values and invests in those experiencing care and those providing it.
11. The Scottish Government should work with partners to develop a more coordinated approach across health, social care and local council services to refer carers to third sector and community support including, in particular food support and fuel vouchers, vital to protecting health and well-being.
State of Caring 2023: A health and social care crisis for unpaid carers in Scotland
Carers Scotland is Scotland’s membership charity for unpaid carers. They work to represent
and support the approximately 800,000 people in Scotland who provide unpaid care for ill,
older or disabled family members or friends – fighting for increased recognition and support
for all carers and to ensure they have a voice in the issues that affect them.
Quite simply, action is needed, and it is needed now.
Top picture: Labour councillors Michelle McGinty and Clare Steel pictured with SNP MP Martin Docherty Hughes and group of Kinship Carers – people who look after members of their family – in West Dunbartonshire.