A carer is someone who provides support to a family member or friend who would otherwise not be able to manage. Care roles are diverse and might include looking after young children or someone who is disabled, ill, frail or who has a substance misuse problem. The role is unpaid, and often unacknowledged.
It is often the case that people may not self-identify as a carer as the role may be viewed as a being part and parcel of their responsibilities as a supportive family member or friend. Asking someone to imagine a separation between their role as spouse, parent, sibling, child or friend from that of their care role with that individual may be a difficult, if not impossible task.
The care role, a role that should not strictly be viewed as voluntary, can place strain on individuals as they try and balance their own needs with the needs of the person being cared for. Achieving this balance may sometimes be challenging, resulting in carers subordinating their own needs to that of their loved one.
Depending on the acuteness and onset of the caring role, the carer may often find themselves having to adapt to emotional and perhaps physical strains of caring, along with the altered family and social relationships, that may result. In many instances, carers are ‘hit’ twice, firstly from the worries and pressures of caring for a loved one, but also because of the lack of time to socialise, or continue meaningful employment might also be affected. The social support networks in these activities are important ways of relieving pressure and mitigating stress.
People drawn into a caring role may face challenges in trying to balance caring responsibilities with paid employment. As a result, carers might be compelled to reduce working hours, or even decide to give up working entirely.
Those who decide to remove themselves from the workforce face not only constrained economic circumstances, but also the loss of an important social network and support mechanism. While carers may sometimes feel they face little choice but to give up work, in NHSScotland, a range of flexible working policies and advice sources exist to help carers manage work responsibilities around their personal lives.
Carers successfully utilising these policies and sources of advice, may be able to negotiate different working patterns, or take a brief period of time off to manage personal commitments or deal with the immediacy of a situation.
This site is designed to help NHS Scotland staff members who are carers, and their managers, by outlining the relevant work-life balance policies, along with directing users to relevant internal and external sources of advice and assistance.
Caring roles can develop in a variety of ways. At the extremes, they can arise suddenly following an accident or sudden illness onset, or evolve slowly in the case of a parent developing dementia. The diversity of care roles also mean that the challenges facing carers will differ. Caring for a parent with dementia will differ markedly from caring for a spouse who has had a stroke or heart attack. The responsibilities and concerns of these carers will also be very different from the parent who has a disabled child with complex needs. You may wish to think about Power of Attorney and the Office of the Public Guardian website may be useful. Regardless, carers are compelled to adapt to altered familial and social relationships, developing new coping mechanisms and skills along the journey.
Developing an appreciation of the journey carers will undertake, requires an understanding of its various stages. While many carers may be familiar with the various stages outlined in the following presentation, colleagues and managers may be confronted with this framework for the first time. It is important to note that the ‘stages of caring’ outlined in the following presentation, are not rigid, nor should they be viewed as linear and ‘one-way’ milestones along the journey. The dynamic nature of the care role may see carers spanning more than one stage, or even skip stages as they adapt and respond to the changing circumstances.
As part of the Working Well programme, the Scottish Government has committed itself to improving and promoting health and well being, and preventing ill health within the workplace. (Ref: Safe and Well at work) It is recognised that as a result of their circumstances, carers may be more vulnerable to stress, potentially impinging on an individual’s mental and physical well being. The Working Well strategy on the promotion of physical and mental well being in the workplace dovetails with the Scottish Government's more recent commitment to carers in Scotland.
In July 2010, the Scottish Government, in partnership with the Convention of Local Authorities in Scotland (COSLA), local NHS Boards, and national carers organisation, established the Carers Strategy for Scotland. This can be reviewed in the resulting document: Caring Together: The Carers Strategy for Scotland. Outlined within the 10 headline actions, is the recognition that carers can suffer poor health as a direct consequence of caring, highlighting the increased vulnerability of carers to stress and ill health. Also highlighted in these headline actions, is the importance of carer friendly employment practices and policies that can assist carers remain in, or take up employment if they so wish.
An example of these employment policies can be found in the Supporting the Work-Life Balance PIN policy, wherein NHS boards are tasked with promoting an organisational culture of work-life balance. The policies within the document, are designed to assist the organisation balance the needs of the staff with the requirements of delivering a high quality service. Supporting the Work-Life balance PIN
Employee policies relating to carers in the NHSScotland work force can be found within the Supporting the Work-Life Balance PIN policy. This policy document outlines a minimum standard of practice which NHS Boards should use to develop local employee policies. While individual NHS Board policies for carers may differ slightly in wording and structure, each NHS board will negotiate local policy using the guiding PIN as a minimum standard, adapting them in line with local needs. The adaption of policy is done with input from both employer and employee representatives. Supporting the Work-Life balance PIN
Where can I find the Scottish Government PIN policies and my own NHS Board policies?
The Supporting the Work-Life Balance PIN policy can be located on the Staff Governance website, while local NHS Board policies can be found on your own NHS Board intranet site. Managers and staff can obtain guidance on the use of relevant policies from their local Human Resource department.
My NHS Board doesn’t seem to have a ‘Carers policy’?
All NHS Boards will have a range of work life balance policies relevant to carers, though they might not have strictly called them ‘carers policies’. Carers policies sit under the umbrella of work-life balance policies that include ‘Carer Leave’, but there will be many other policies that are designed to help staff achieve a healthier work-life balance, specifically the range of flexible working policies.
Policies relating to carers can be placed into two categories. One dealing with short term provisions such as emergency leave, the other relating to long term provisions.
This policy is useful for carers who might need to organise leave on short notice such as responding to an emergency, or a breakdown of caring arrangements. The policy allows for up to a period of 1 week of paid leave, (with the possibility of an extension of up to a further week upon the discretion of the manager).
See your local NHS Board policies on your intranet to review the specifics of how to ascertain how to go about using these policies.
Sometimes, carers may benefit from making more structural changes to working patterns, such as altering or even reducing working times. Flexible work policies allow for such contingencies, and all staff have a right to request these. In turn, managers, have a duty to consider any such request seriously and to consider how flexible working may contribute to a healthier work-life balance for staff.
Note, that local NHS Boards may not define these as carer specific policies, however, they nonetheless can be an important tool in helping carers achieve a healthy work-life balance. The following are an example of potential flexible working provisions that may be useful to carers and managers in the NHSScotland workforce.
Job sharing
Where two or more people share the responsibilities of one or more full-time posts, dividing the hours, duties and pay between them.
Reduced working year
Where people work during fixed periods such as the school term and/or during school hours but not during school holidays.
Flexible working hours
Where staff can:
- Choose their own start and finish time around fixed core hours
- Use periods of work of differing lengths within an agreed overall period
- Compress longer working hours into a shorter working week
Annualised hours
Where people work a specific number of hours each year, with the hours unevenly distributed throughout the year.
Home working
Where, if possible, people work from home for all or part of their hours.
Career break policy
Which details provision for staff who wish to have longer periods of time off without giving up employment. This may be particularly useful during periods of increased stress or strain in the care relationship.
Procedures on how to request or arrange flexible working provisions can be discussed with managers as well. Further information can be found within the Supporting the Work-Life Balance PIN Policy. Supporting the Work-Life balance PIN