Joint working

This chapter explores working partnerships with carers of older people and particularly carers in full or part-time employment who may have many stresses and conflicting demands in their lives. The legal and social context of caring is traced from The NHS and Community Care Act (DH, 1990) and subsequent care in the community initiatives. Another milestone was The National Strategy for Carers (DH, 1999a), though there has only recently been a government commitment to partnership with carers against very patchy previous provision.

It is ten years since Valuing People promised a ‘new deal’ for family carers. Valuing People was explicitly concerned to ensure a cultural shift in the way services worked with and conceptualised the role of family carers. It included specific objectives for involving families in local partnership boards, providing better support for them in their caring role and investing in family leadership nationally, regionally and locally. This article considers why there was a need for a more family-focused approach to support.

The tasks provided by young carers, the support - or lack of it - on which they can draw and the effects the duties can have on their education.

It is estimated that carers carry out the equivalent of 57bn of caring a year. So, health and social services need to work together to support carers in their valuable, and often unrecognised, work.

On the 1st of April 1999 Somerset Health Authority and Somerset County Council established a Joint Commissioning Board (JCB) to commission mental health services. Simultaneously, the Somerset Partnerships Health and Social Care NHS Trust was set-up as a combined health and social care services provider; for the first time in England, the majority of social services mental health staff transferred their employment to this Trust. The JCB commissioned an evaluation of the impact of these innovations on users and carers, staff and senior officers and members in the organisations concerned.

This paper outlines two challenges to community nurses as they work with unpaid carers. These reflect a changing culture in the way that healthcare will be delivered in the coming decade. The first of these challenges is a shift towards focusing on outcomes for both service users and adult carers. Outcomes evidence the impact a service has on a person's life. The second is the increasing focus on the concept of carers as partners in care. 

An interactive toolkit, developed to support the implementation of the Social Services and Wellbeing (Wales) Act, which provides information and advice to support Local Authorities and Health Boards to undertake an assessment of care and support needs and carers' needs in their local area. The toolkit is in three main sections. Section one (the ‘What’ guide) looks at what is required under the Social Services and Wellbeing (Wales) Act, the benefits of carrying out an assessment, analysing the data, and what should be included in the report.

Reports on the development of a joint mental health strategy for older people in a central London Borough. The project brought together clinicians and practitioners from a variety of settings, the voluntary sector, and users and carers. The aim of the project was to develop a shared philosophy of care based on promoting independence and from this to identify the components of a spectrum of care that would meet the wide range of needs of elders with mental ill health. The borough had high levels of deprivation, unemployment and poor housing.

This article describes how Thurrock Council Social Services Department and South Essex Mental Health and Community Care NHS Trust launched a joint initiative to develop an integrated service strategy and implementation plan for older people's mental health services in Thurrock. The main principles of the approach were: service user and carer involvement, the active participation of mental health professionals working directly with service users and carers, representatives from all key agencies involved in the planning process.

The new white paper in England is an opportunity for services to stop and think about their relationship with families. This article looks specifically at the situation of older family carers and why services often fail to 'make sense' to them. It shows that these families often do not get the support they need, leaving them in great anxiety about the future. Examples are given of practical initiatives that have worked successfully with older families.