Today's NHS five year forward view confirms that unpaid carers, it seems, are emerging from the shadows in terms of recognition, at a policy level at least.
Six years on from the introduction of the carers strategy in England , we are making some progress. At two out of the three major UK party conferences this year, carers were mentioned from the platform as a key health manifesto priority. The Care Act for the first time gives carers parallel rights to the people they care for , the Better Care Fund guidance requires local plans to indicate how the intend to support carers. and NHS England has produced its commitment for carers pledges
It you're an advocate for carers, you can't help but be pleased with an increase in profile of the issue. However let's be under no illusion. The reason policy makers are interested in carers is because they know they are the people mopping up vast amounts of care that the state can increasingly not afford to provide. All across the UK, family members, including children as young as 4 and older people in their nineties take on caring responsibilities - not always because they want to or are equipped to, and often to their own detriment, but because simply they see no other acceptable option. And for as long as they go on, the state doesn't have to step in.
Progress is positive but a host of finely worded documents just aren't enough. Talking to carers, in Carers Trust's network of 175 local carers support services, we find that many still aren't experiencing any real change. Carers are still struggling to be the link between health, care and other professionals whose priorities do not revolve around ease of use for the person needing care, let alone the carer. The focus on integration - the holy grail - is welcome, however, as much as we need linking up of health and social care, the effective linking up of health professionals who still often seem incapable of communicating effectively amongst themselves would be a start.
Most carers still find their own health outcomes compromised. The 2011 census found that the more hours someone is caring a week, the less good their health is. Poor physical and mental health amongst the caring population is endemic. With around 7 million carers in the UK, this amounts to a serious public health issue.
And still far too few carers find their way to support tailored to meet their needs - often because they do not realise they are a carer or that there might be anything there to support them- they simply think of themselves as someone's wife, dad, partner, son, friend.
For carers, health professionals are key. They are the people who are in a position to know someone has a caring role, and to help them to self identity. But we are still a long way from persuading many GPs and their practices that this is a role they need to take seriously, partly due to lack of effective financial incentives.
We have been round the houses on this issue too many times. We have cajoled, negotiated, reasoned, persuaded and presented good practice till we are blue in the face but it hasn't been enough to achieve the change we need.
Local authorities now have a duty to assess carers based on the appearance of a need for support, and it is time the NHS took its responsibilities to the 5.8 million carers in England seriously too. It's time for the introduction on a new legal duty on the NHS to identity carers for support.
It's time to think wider than patient - it's time to think carer too. And it's time to stop allowing it to be someone else responsibility .