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Strategic commissioning for adult carers’ breaks

Commissioning is about having the most effective approaches and support in place in order to improve outcomes.

Stakeholders may be interested in different outcomes, so it is important to be clear about the respective benefits of breaks. Local authorities and health services have legal duties to develop integrated approaches for the benefit of individuals. Effective commissioning cannot be achieved in isolation. It needs to be co-produced with local people and by close collaboration with adults and children services, public health, housing, NHS partners and the wider community.

Knowing what’s on partners’ agendas and understanding their priorities will help identify opportunities to embed the breaks agenda across a wider platform.

How can you ensure carers’ breaks are everybody’s business and cross strategic agendas?

  • Identify relevant reporting mechanisms and outcomes measures. How do your plans for breaks contribute to the local Adult Social Care Outcomes Framework (ASCOF) and the Public Health Outcomes Framework (PHOF)? What reporting on breaks is of interest to the local ICS and mental health trust?
  • Social prescribing – how is this working locally for carers? Can breaks become a clearer part of this?
  • The NHS Plan identifies that carers’ health is generally poor. How can you evidence the health benefits of breaks? How are these reflected in plans for integrated care services or sustainability and transformation partnerships (STPs)?
  • Health and wellbeing board – has the board understood the needs and agreed priorities for breaks?
  • How can you thread carers’ needs through local community plans, housing plans or equalities plans? This might be in relation to employment, ageing well, access to leisure, community engagement, or tackling isolation and loneliness.
  • Don’t forget the role of local businesses as employers, as part of the community, their corporate social responsibility (CSR) commitment and as part of the breaks offer. My Time, Liverpool demonstrates fantastic community gains that are positive for business too.
  • The local chamber of commerce may have plans and some businesses may be part of Employers for Carers.

Anna McEwen, Executive Director of Support and Development, Shared Lives Plus

Funding carers’ breaks

Each area needs to develop its own costed plans to address how carers’ breaks are to be funded. This will include funding from existing social care and health budgets for support packages or via personal budgets. It will also include, where appropriate, individuals funding their own arrangements.

To identify funding for the development or provision of breaks, commissioners will want to consider local approaches for preventive budgets, invest to save and innovation plans. Wider strategic agendas, such as tackling loneliness, improving mental health services, may have funding attached that could support carers’ outcomes.

Tim Anfilogoff, Community Resilience, Herts CCG

Better Care Fund

Funding for carers breaks is included in the NHS allocation to the Better Care Fund (BCF). The BCF is a pooled fund that exists in each local authority area. NHS and local authority commissioners agree a plan for the use of their pool that supports person-centred, integrated care for local people. These plans must include a joint approach to supporting unpaid carers and identify resource from the BCF pooled fund to support carers services.

Commissioners of carers services should be involved in this process, as well as local VCS groups. The Better Care Exchange, a collaboration site that is part of the NHS Futures platform, has some examples of good practice in Swindon and Portsmouth in carer support from BCF plans.

Social prescribing

Social prescribing and universal personalised care, both key commitments in the NHS Long Term Plan, may be additionally be relevant in addressing carers’ needs for breaks. GPs and primary care professionals can use social prescribing to refer to a range of local, non-clinical services or activities to address people’s needs in a holistic and personalised way.

NHS England allocations to integrated care boards (ICBs)

Local authorities, as part of their information and advice service, should seek to make available potential sources of funding for breaks for individual (self-funding) carers. The national organisations such as Carers UK and Carers Trust provide information about grants and funding for breaks and holidays.

See also: NHS Commissioning for Carers

Hazel Brown, Liverpool Carers Centre

Practice examples