What evidence is there for effective intervention?
Our health, our care our say (Department of Health, 2006)
Sets out the government’s commitment to put people more in control and make services more responsive to the needs of individuals. Innovation is encouraged to allow greater service user choice and there is an emphasis on prevention and earlier intervention and more support to maintain mental health and emotional well-being.
Recognised, valued and supported (Department of Health, 2010a)
Sets out the support needed by carers to maintain / improve their health and well-being and to carry out their caring role in four main areas:
- Supporting carers to identify themselves as carers at an early stage
- Enabling carers to fulfil their educational and employment potential
- Provision of personalised support for carers and those they support
- Supporting carers to remain mentally and physically well.
Carers and Personalisation: improving outcomes (Department of Health, 2010b)
A guide on emerging evidence, including examples to illustrate how the principles of personalisation have been applied, emphasising the value of finding ways forward that make sense and work best locally. Includes:
- Carers as expert care partners & whole family approaches
- Early intervention and prevention
- Making self-directed support processes work for carers.
New Approaches to Supporting Carers’ Health & Wellbeing. (Centre for International Research on Care, Labour & Equalities & University of Leeds 2011)
This programme was developed by the Department of Health as part of its commitments made in the National Carers Strategy in 2008. The commitments included new measures to improve carers’ health and well-being. The programme focused on breaks, health checks and better NHS support for carers. Sites looked at new and innovative ways to engage with carers and deliver services.
The programme was delivered over 18 months and supported over 18,500 carers. Analysis of the programme produced evidence-based conclusions and recommendations for improving carer support services:
- Breaks from the caring role enable some carers to build confidence and some to change their behaviour and activities which can be beneficial to their health and well-being and improvements to ability to communicate. Flexible and personalised breaks are life enhancing for carers and have the potential to prevent “burn-out”/ health deterioration and so sustain their caring role.
- Health checks for carers have a positive impact. Four months after implementing health checks one-quarter of carers reported how they looked after their health and the amount of exercise they took had improved. Health checks can lead to sustained self-care and healthier behaviour for carers.
- Creative and innovative approaches which are flexible to support delivery are more effective than standardisation.
- Success can be achieved by establishing carers’ champions in GP practices linked to other partner agencies. In hospital successful practices included ward-based initiatives which involved nurses, doctors and health care assistants and made services and support available in the hospital setting.
- Services need to be accessible from a variety of venues to suit carers’ circumstances and at key points in the carers’ journey, especially when caring first arises, at points of stress and on a regular basis when caring is long-term and intensive.
- More effective support is achieved by local authorities, NHS organisations and voluntary organisations working together and this partnership should be strengthened in all localities.
- Local carer support partnerships will develop more effective services by involving a diverse range of carers in service development and should offer them suitable training. Partnerships should work with carers to review carers’ needs, identify local priorities for developing carer support and selecting the leading and supporting agencies needed to deliver different types of carer support services.
- In delivering support to a wide range of carers and reaching carers not already in touch with services, local partnerships should work flexibly and sometimes on an ad hoc basis to engage carers in specific target groups. To establish and sustain support for some groups of carers, flexible networks, where appropriate involving agencies outside the health and social care system which are trusted by carers or which work with people who are carers, may be required.
- Effective carer support at the local level should always include a varied portfolio of carer support services which can be adapted to meet individual needs. Flexible and personalised services should be available to carers in a timely manner and be capable of responding rapidly to carers’ needs.
- Portfolios of carer support need to be agreed locally between local authorities, NHS organisations, voluntary sector organisations and other agencies where appropriate. Carers need support with health, stress, information on how to access suitable support, service available, equipment and home adaptations, income maintenance, self-care, healthy lifestyles and maintaining a life outside of caring, access to education, training, work and leisure; emergency planning and how to access occasional or regular breaks for their caring role.
A review of research on interventions to support carers (Parker et al, 2010) found that:
"The strongest evidence of effectiveness of any sort from our meta-review is in relation to education, training and information for carers." However, they noted that, overall, the evidence base is poor.
Valuing Carers- the rising value of carer’s support: (2015); Carers UK, University of Sheffield, University of Leeds