Being a staff member and a carer in the NHS: who should care?

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As the population ages, and people live longer with disability and health conditions, an increasing number of people in the UK are combining work with caring for older, disabled or seriously ill relatives and friends. In this context, it’s not surprising that of the 1.2 million staff working for the NHS, an estimated 250,000 are also carers.

With the NHS workforce crisis ongoing, in particular in skilled professional roles, supporting NHS staff who are also carers means supporting people to balance their caring responsibilities alongside their work. So it makes sense to pay attention to carers' wellbeing and not lose valuable skills and experience. Sadly, it seems this is frequently not what is happening. The Women in Medicine Carers Network focuses on the specific issues doctor carers face, and have numerous stories of where support was insufficient or non-existent; here is just one.

It's not easy to flex conditions for any front-facing practitioner, but it’s particularly tricky for doctors. Doctors carry the highest clinical risk in the NHS but constitute only 11% of the NHS workforce. Clinical teams have only a handful of doctors – there are community teams of 40 members with just one or two doctors. They often do out-of-hours work, and not every specialty is suited for remote work.

But there are significant benefits to the NHS and patient care in supporting doctor carers. These doctors bring unique and valuable insights to their work because they have seen both sides of the table. They know good clinical care goes beyond a particular treatment. They know the limitations of the system: how compassion fatigue and burnout can creep in among overworked health care professionals, and the importance of a key person holding all the different strands of care in mind. In their role as carers, they have often been that one person, the unofficial care co-ordinator, the one person without whom all the support around the person they care for can collapse. Despite being health care professionals, they know how much they’ve had to advocate in a system that struggles to listen. As clinicians, they know not to give lip service to the patients. Work also gives doctor carers an opportunity to restore their professional identity and contribute meaningfully. Here’s an example of what it can look like when the NHS gets that support right for its staff who are carers:

My daughter has Down’s syndrome and is autistic. She’s also had multiple health problems, needed several stays in HDU and PICU and many trips to theatre. I work in emergency medicine (EM) but was never taught about the barriers to health care and the huge health inequalities faced by autistic patients and patients with a learning disability.

My daughter has taught me so much and inspired me to share this with other emergency clinicians. We all have a role to play in improving outcomes for our vulnerable patients and it starts with raising awareness.

I’ve been lucky enough to have lots of opportunities to do this – writing an infographic about children with Down’s syndrome (with another EM clinician, Linda Dykes), sharing my experiences with NHS England, writing a guideline for pre-hospital clinicians, writing blogs for the Royal College of Emergency Medicine (RCEM) learning and Don’t Forget The Bubbles, speaking at national and international events, taking part in podcasts and putting together study days for RCEM. I learn something new myself every time and am very proud to be able to talk about my strong, funny, stubborn daughter and, hopefully, do my bit to improve things for others like her.

Dr Elizabeth Herrieven, Consultant, Emergency Medicine

The Women in Medicine Carers Network has outlined several steps NHS organisations can take to support the wellbeing of all staff – not just doctors – with caring responsibilities:

  • Formally recognise working carers as the first step in developing effective formal measures and in creating an organisational culture that is supportive of this workforce.
  • Develop carer supportive policies in consultation with working carers – such as carers passport schemes and management training – and become a ‘carer-friendly’ employer.
  • Grant opportunities to carers to work flexibly.
  • Provide all carers with the right to take appropriate periods of paid carers’ leave, involving both statutory and discretionary paid leave.
  • Signpost employees to external sources of information on care and support.
  • Offer counselling and mental health wellbeing guidance.

 

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