Millions of family members and friends are looking after people who couldn’t manage without their support. Although their efforts are often taken for granted, or completely unnoticed, if their help had to be replaced by the state, Carer’s UK estimates that the bill would be more than £132 billion Effectively, the cost of a second NHS! If only 1% of the carers currently supporting someone chose to cease caring tomorrow, it would cost the state well over £1bn.Each caring situation is different but it can often take a toll on people's physical and mental health. Factors like age, trying to stay in work, raising children, additional carer roles, poverty, housing problems and loneliness all increase stress and anxiety. Four-fifths of carers feel they don’t do as much exercise as they should. The national GP survey (135,000 carers responded in 2020) found that a fifth of carers are caring for more than 50 hours per week. It showed that carers experience anxiety, depression and joint pain much earlier and more often than their peers, which could undermine their ability to care.
Given these figures, it’s common sense that, in my role as Head of Community Resilience for the NHS in Hertfordshire, I work closely with the council and voluntary sector on how to prevent some of the health impacts that caring can bring.
Early intervention
A large part of this is identifying carers at risk of health problems early. Before COVID-19 struck, we’d reached 12,000 carers registered with primary care – still only about 22% of the total number of carers in West Herts. We have offered carer health checks and flu jabs. Most GP practices already had carers’ champions within the reception team. And now all primary care networks have social prescribing link workers too, who have more time to listen and find out what really matters to the person.
Hertfordshire has always had a vast range of voluntary organisations, some countywide, some very local. Before social prescribing people couldn’t always find the way to the right help for them. Carers in Herts (our county carers’ organisation) demonstrated, even before they employed link workers, how focusing on what mattered to the carer could identify low-cost interventions that reduced the risk of carer depression by over 20%. Sometimes it was the provision of a laptop or a tablet, sometimes a gardening course, an adult learning class, a massage, or a weekend away. It just had to be something the carer would value, not what someone else thought was best for them.
Focusing on what matters
Now we have a formalised role responsible for this. A link worker can focus on what matters to the person in front of them, explain the benefits of local carers’ support groups, but also find other support through counselling, mindfulness, stress-busting arts and crafts activities as well as carer-specific services.
In March 2021, Public Health England published a key document Caring as a social determinant of health, which as well as acknowledging carers’ huge contribution to the NHS, showed how important non-clinical interventions like social prescribing can be.
Caring will always be difficult, unpaid work. But there are 1500 link workers in primary care in England now working to make sure people find the help they need. It’s never been more important to join it all up and make sure support for carers is part of the local social prescribing plans all PCNs are required to have.
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Tim Anfilogoff is Head of Community Resilience at Herts Valleys CCG, and NHS England’s Social Prescribing Regional Facilitator for the East of England.
