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JSNA Chapter: Young Carers and Young Adult Carers

Section: People & Society
Next Review Date: 31/03/2019
Date Published: 12/06/2014

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Contents

  1. Introduction
  2. Who's at risk and why?
  3. The level of need in the population
  4. Current services in relation to need.
  5. Projected service use and outcomes in 3-5 years and 5-10 years.
  6. Evidence based (what works and what does not work)
  7. Unmet needs and service gaps
  8. Equality Impact Assessment
  9. Recommendations for Commissioning
  10. Recommendations for needs assessment work
  11. Key contacts
  12. Chapter References
  13. Signed off by


Introduction

A young carer is a child or young person under 18 who provides regular and ongoing care and emotional support to a family member who is physically or mentally ill, disabled or misuses substances. The term young carer does not apply to everyday or occasional help that may occur in all families. It is specific to care that is relied upon in maintaining the health, safety or day to day wellbeing of the person receiving support or care (1).

A young adult carer in Surrey is someone who is aged between 16 – 24 years old. This age group includes 16 – 17 year olds (who are legally children) and 18 – 24 year olds (who are legally adults) (2).

The 2011 census shows 6021 children and young people age 0 – 24 years old are providing unpaid care in Surrey. However based on research conducted by the University of Nottingham and the BBC it is estimated that there are 14,030 children and young people aged 0 – 18 years old who are young carers in Surrey (3). This means there are a large number of unidentified young carers and young adult carers who are not receiving support.

From April 2015 the Children and Families Act 2014 (4) will give young carers the right to an assessment of their needs for support. The new legislation will affect all services working with an adult or a child who is cared for by a young carer.

The Care Act 2014 (5) reinforces adult carers’ right to an assessment; this includes the same rights for young adult carers aged 18 – 24 years old. It also clarifies the local authority’s responsibility for carers who are under 18 years old during transition to adulthood. The Care Act 2014 stipulates that support should be provided by Adult Social Care to ensure no young carer is relied upon to provide an inappropriate level of care to an adult.
The Surrey Interagency Strategy for Young Carers 2011-14 (6) is being refreshed this year 2014. A multi agency action plan is also produced as a document for ongoing work against the priorities from the strategy.

Key issues and gaps

  • The number of young carers and young adult carers identified could increase as awareness is raised following new legislation.
  • Clarification is needed for who will be responsible for the assessment of young carers if the person being cared for is not receiving a statutory service.
  • Strains on emotional wellbeing for young carers and young adult carers have been identified as a concern in the two surveys completed in Surrey.
  • It is important to recognise the needs of young adult carers during the transition to adulthood.
  • Young carers caring for someone suffering substance misuse face more barriers to seeking support.

Recommendations for Commissioning

  • Thresholds need to be reviewed in line with new legislation.
  • Consider if specific services need to be commissioned to support young carers’ emotional wellbeing.
  • Training for professionals in identifying young carers and supporting them through an early help assessment.
  • Empower schools to identify and support young carers.
  • The action plan from the Surrey Young Carers Health Survey Report 2013 (7) should be considered by commissioners.
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Who's at risk and why?

Children and young people with parents or siblings who have a mental illness or suffer drug and/or alcohol misuse
Research by the Association of Directors of Adult Social Services (ADASS) and the Association of Directors of Children's Services (ADCS) identified that there are challenges in the self identification of children and young people who support a parent with mental illness or drug and/or alcohol misuse. Where early identification does not take place, disclosure tends to happen at crisis point (8). Children and young people can become isolated due to the stigma of a parent with mental illness. They can also feel confused by their parent’s illness and it is important that information about their condition is explained by professionals supporting the family (9).

Children and young people with parents or siblings who have a physical or sensory disability
Young carers and young adult carers may be at risk of injury providing physical support to the person they care for. They are also more likely to provide intimate care. (10)

Children and young people caring for someone who needs medication
Young carers and young adult carers may be relied upon to administer medication to the person they care for. This can be a worrying task for a child or young person who may feel responsible that one mistake could be fatal (11). Responsibility of giving out medication and responding appropriately in an emergency add pressure for a young carer or young adult carer.

Children and young people caring for someone with life threatening and life limiting conditions
The strategy for public health in England recognises that if the person being cared for reaches a critical point unprepared, carers are at risk of experiencing a traumatic bereavement with associated mental and physical health issues (12).

Children and young people who are heavily involved in caring
“Heavily involved” young carers and young adult carers are the most likely to need formal health and social care support. “Heavily involved” may not necessarily mean long hours of care, but means a young carer is taking on “adult like responsibilities and where caring roles impact on their own psycho-social development, health, education and wellbeing” (13). Young people become more heavily involved in caring as they get older (14) so young adult carers are at risk of being relied upon for a level of care that is inappropriate or uncomfortable for them. Research in Surrey identified that no young adult carers report being “at ease” with their caring role and that most carers in this role felt restrained by this relationship as they got older (15).

Special Educational Needs and Disabilities (SEND)
Young carers are 1.5 times more likely to have a disability, longterm illness or special need (16).

Black and minority ethnic (BME) groups
Research in Hidden from View found young carers are 1.5 times more likely to be from BME communities and are twice as likely not to speak English as their first language than peers. However previous data shows that children and young people from BME communities are often less likely to self identify (17). Adults from the Gypsy Roma Traveller (GRT) community are more likely to suffer chronic ill health or suffer more than one health condition (18). This could increase the risk of GRT children and young people becoming young carers and young adult carers.

Families in poverty
The average annual income for a family with a young carer is £5000 less than those who don’t have a young carer (19). Families with less disposable income may have less choice and become reliant on informal care where they are unable to fund other care options. Higher disposable income could take some of the pressure from the type or quantity of care a young carer is relied upon for (20).
 
Children and young people in single parent homes
Children and young people from lone parent families are more likely to take on caring responsibilities if there is no other responsible adult available to provide care. In two parent families where one parent works away from home it is also more likely that a child or young person will be the caregiver. This happens more often in cases where the parent in need of care is female. Results of three national surveys of young carers showed over half of the young carers were from lone parent families and most were caring for ill or disabled mothers (21).

Education, Employment or Training
Caring responsibilities can impact attendance and engagement with education services and this continues to affect young carers as they get older. Young adult carers under 20 years old are more likely to be not in education, employment or training (NEET) (22). A survey of young adult carers who were either in employment or NEET found that progress both in work and education can be hindered by caring responsibilities. The concern for young adult carers is that a caring role at this stage in life can affect future life opportunities (23). 
 


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The level of need in the population

Figure 1: 0 – 24 yr olds providing unpaid care (24)

Region

All people 0 to 24
years old

All people 0 to 24
years old providing
unpaid care

All people 0 to 24
years old providing
20 or more hours
unpaid care

All people 0 to 24
years old providing
50 or more hours
unpaid care

England

15,884,382

403,603

102,571

44,182

Surrey

321,888

6,021

1,186

471

North East Surrey

87,390

1620

343

131

South East Surrey

85,355

1683

339

136

North West Surrey

76,866

1481

270

113

South West Surrey

72,277

1237

234

91

Source: Census 2011. Available on Surreyi

The results of the 2011 census show that there are 6021 children and young people age 0 – 24 years old providing unpaid care in Surrey. The estimated number of young carers aged 0 -18 years old in Surrey, based on findings from a BBC and University of Nottingham survey in 2010, is 14,030 (25). The number of young carers identified in the census is far below the number estimated therefore there are likely to be young carers who have not been identified by the parent/carer completing the census.

Young carers and young adult carers receiving a service from Surrey Young Carers

Figure 2: Age of the Person Cared for
agegroupofthepersoncaredfor.jpg
Source: Surrey Young Carers data 2013/14

In 2013/14 36% of young carers were caring for someone under 18 and 52% were caring for an adult over 18 years old.

Figure 3: Main health condition of the person cared for
mainhealthcondition of personcaredfor.jpg
Source: Surrey Young Carers data 2013/14

The highest percentage of cared for people have physical/sensory difficulties as a main health condition followed closely by mental health. However in 46% of cases the health condition was recorded as multiple or other, which makes it difficult to see an exact picture. Less than 2% of those being cared for have a main health condition of substance misuse. This may be due to the stigma and barriers to seeking support where the person being cared for is suffering drug or alcohol abuse (26).

Early Help (27)

54 young carers received support through a CAF or Early Help Assessment in 2013/14. This is approximately the same number as 2012/13. More CAF/Early Help Assessments were completed for male young carers in 2013/14; 57% for males compared to 37% for females.

In addition:

  • 20% of young carers who were supported by a CAF/Early Help Assessment in 2013/14 were from a non white British background compared to 30% for all CAFs/Early Help Assessments.
  • All of the female young carers who were supported by a CAF/Early Help Assessment in 2013/14 were from a white British background

The Surrey Safeguarding Children Board has published a Levels of Need document, as required by Working Together to Safeguard Children 2013. This provides guidance to professionals on when it is appropriate complete an Early Help Assessment and when the threshold is met for a referral to Children's Services. These guidelines include guidance specific to young carers under “family and social relationships” (28). This is only one factor and a young carer may need a higher level support if there are other factors alongside caring or impacted by their caring responsibilities such as but not exclusive to; domestic abuse; parent struggling to provide adequate care; concerns regarding physical and emotional development.

The Levels of Need document will need to take into account changes in legislation in relation to young carers. If they are caring for a child or they are a child in need this assessment will be the responsibility of Children’s and Safeguarding Service. However there is not data available to inform how many young carers are currently receiving a service from Children’s and Safeguarding Service.

Young carers of adults who are known to Adult Social Care
Under new legislation Adult Social Care will be responsible if the person being cared for is an adult unless the young carer is a child in need. At the beginning of 2013 Adult Social Care began recording young carers who were identified as caring for an adult receiving a service. At the end of December 2013 148 young carers had been identified on the Adult Social Care electronic system (29). As there were 1299 young carers caring for an adult supported by Surrey Young Carers in 2013/14 it is likely that the number identified by Adult Social Care will continue to rise.

GP Carer payments
From April to December 2013 there were only 13 GP carer payments made to children and young people under 18 years old (1870 GP carer payments were made to people over 18 yrs old and 26 payments were made where the age of the carer was not known)(30). This means that a very small percentage of GP carer payments are paid directly to young carers in their own right. Some of the payments to adult carers may be benefitting young carers who provide additional care but this is not recorded. From 1st April 2014 the GP Carers Prescription Service has been rolled out which allows GPs to directly refer young carers for support using an online system. NHS England will consider how carers can be supported through commissioning of primary care including developments to the GP contract and enhanced services as a commitment by March 2015 (31).

Surrey County Council Young Carer Payments
Young Carers can also access direct payments through Surrey County Council. In 2012/13 there were 399 payments of up to £500 paid to young carers. 132 payments were through statutory teams and 267 were through early intervention payments agreed by Surrey Young Carers. The number of young carer payments increased by 34% in 2013/14 when there were 536 payments made to young carers (32).

Impacts on emotional health
The Surrey Young Carers Health Survey 2013 found that 35% of respondents recognised they experienced the symptoms of an eating disorder with 10% relating this specifically to their caring role. Harmful coping mechanisms such as self-harm, alcohol misuse or smoking may exacerbate health problems for young carers. When asked how caring affected their health there was a high response for factors that affect emotional health and wellbeing. 65% of respondents had felt stressed, 50% had felt anger, 28% had experienced depression, 28% had felt anxious and 9% had self harmed (33). 
 

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Current services in relation to need.

Universal Services (also known as level 1 services)

Primary and Secondary Schools
The Healthy Schools Programme offers guidance to schools regarding young carers. Child and Adolescent Mental Health (CAMHS) offer ‘Everybody’s Business’ training to staff in schools (and other agencies) to increase mental health awareness for staff and improve access to mental health advice and support for children and young people.

Education advisors who are employed by Surrey Young Carers can assist schools in identifying and supporting young carers. Surrey Young Carers provide recommendations to schools about how to support young carers including free training, briefings and guidance on implementing tools such as the education support plan.

The Interagency Strategy for Young Carers in Surrey 2011 - 2014 Multi Agency Action Plan (34) gives an action to enable tracking of young carers through the education system. Currently there is not a system in place that all schools can report the number of young carers attending their school. The Strategy is being reviewed during 2014.

GP surgeries and 0 - 19 teams
0 – 19 teams consist of health visitors, school nurses, CAMHS community nurses, staff nurses and community nursery nurses. GPs and 0 -19 teams may be the first services to identify and support a young carers health needs whether they are working with the child/young person directly or the person being cared for. The Royal College of General Practitioners have provided guidance for GPs in supporting carers which includes suggestions of ways to improve identification of young carers (35).

Early Help Services (also known as level 2 services)

Early Help Approach
All agencies may offer support through an Early Help Assessment and Team around the Family. Young carers undertaking occasional caring responsibilities can be supported in this way. The Early Help Assessment is an important tool for any agency working with a young carer or the person they care for. It offers a whole family approach which is key to ensuring young carers are supported.

Surrey Young Carers is part of registered charity Action for Carers and supports carers who are under 18 years old. The service provides:

  • One to one support
  • Advice and advocacy
  • Groups and workshops
  • Residential breaks
  • Activities
  • Support with school/college
  • Supports young carers in having a voice
  • Newsletter
  • Online information
  • Training for professionals
  • Education Advisors providing advice to schools and colleges

Action for Carers also support carers who are over 18 years old. This includes support for young adult carers aged 16 – 24 years old. Action for carers created Be informed an interactive booklet aimed at young adult carers 16 – 24 years old (36). The role of Learning and Work 16 - 24 Development Officer was commissioned from recommendations in Research into Young Adult Carers aged 16 – 24 in Surrey. The role means there is specialist support for young adult carers in regards to learning and work.

Carers Support
There are 10 independent local Carers Support organisations covering all parts of Surrey. Although these services provide support to adult carers they are important in helping identify where there are young carers in the families they support and making appropriate referrals for support.

Surrey Family Support Programme offers a whole family approach co-ordinating a team around the family. Currently the programme works with families where there is poor school attendance and/or exclusions, crime/anti-social behaviour and unemployment benefits. Although there is not a specific remit to work with young carers there may be young carers identified in the families who are supported by the programme, as young carers may be missing school and are more likely than peers to be from a family with financial difficulties.

There are plans to widen the criteria for the Family Support Programme. Parental mental health issues and substance/alcohol misuse are being considered as factors in families the programme will work with (37). This may increase the number of young carers identified and supported through the Family Support Programme.

Services for Young People recognise that young carers are at greater risk of being not in education or employment (NEET). The Young People’s Employability Plan 2012 -17 shows a commitment to working with vulnerable groups such as young carers to promote the benefits of participation (38). Services for Young People’s document The Young People’s Outcomes Framework names those with caring responsibilities as a target group. Target groups are groups of young people where there is an aim to improve outcomes and reduce inequalities (39).

Army Welfare Service
The Army Welfare Service is a professional and confidential welfare support service for Army personnel families. Young carers and young adult carers in military families may be caring for a parent injured in service or suffering post traumatic stress. They may also become a carer for a parent who is suffering ill health when the parent in service is away.

Emotional Wellbeing
As well as counselling services that can be accessed through the GP there are free confidential services available to young people in Surrey:

  • Heads Together (East Surrey) – Up to 12 weeks free counselling to young people aged 14 – 24 years old.
  • Youth Counselling Service (West Surrey) - Free counselling service for young people aged 12 – 24 years old.
  • Further services can be found through Youngminds, a charity committed to improving the emotional wellbeing and mental health of children and young people. See www.youngminds.org.uk

Targeted Services (also known as level 3 services)

Children with Disabilities Teams
The Children with Disabilities team may identify young carers who are siblings of a child or young person receiving a service. Currently the Social Worker in the Children with Disabilities Team will consider the needs of the young carer as part of the sibling’s assessment. Services can be accessed for the young carer by the Social Worker in the Children with Disabilities Team.

Children’s Services Area Teams
A young carer may be supported through a Child and Family Assessment if there is a concern they are a child in need.

Surrey Adult Social Care support young carers as part of the whole family approach (40). A Young Carers Assessment is currently being developed with Surrey Young Carers in preparation for the changes in the Children and Families Act 2014 which come into force from April 2015.

Surrey CAMHS (Child and Adolescent Mental Health Services) deliver preventative services and treatment to children and young people with mental health problems. CAMHS may become involved with a young carer who has a mental health need or they may be working with the person the young carer is caring for. CAMHS also provide Targeted Mental Health in Schools (TaMHS). See www.surrey-camhs.org.uk

Specialist Services (also known as level 4 services)

Children’s Services Area Teams
If a young carer is the main carer or providing an inappropriate level of care and is at risk of harm they may become subject to a child protection plan or become a looked after child.

Referral routes to Surrey Young Carers

Figure 5: Referrals by source type to Surrey Young Carers 2012/13 and 2013/14
sourceofreferralSYC.jpg
Source: Surrey Young Carers data 2012/13 and 2013/14

In 2013/14 36% of referrals came from “Education”. Voluntary organisations made 17% of the referrals and Children’s and Safeguarding Service 16%. The figures from 2012/13 are different due to “education” and “parental” not being recorded as a category until 2013/14. There was an improvement in reporting the referral routes rather than there being a change in the people referring to Surrey Young Carers.

Services completing the Common Assessment Framework or Early Help Assessment

Figure 6: CAF/Early Help Assessments for a Young Carer by Lead Agency
numberofCAFEHAbyleadagency.jpg
Source: Early Help data 2013/14

Schools were the lead agency with 54% of the CAF/Early Help Assessments completed for young carers in 2013/14. This compares to schools being the lead agency with 27% of all CAF/Early Help Assessments. This shows that schools are key in identifying and supporting young carers.

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Projected service use and outcomes in 3-5 years and 5-10 years.

The changes for local authorities in identifying and supporting young carers informed by the Children and Families Act 2014 are expected to be put into practice in April 2015 (41). As awareness increases more agencies may identify young carers and more families may recognise when a child or young person is a young carer or young adult carer. This should result in the numbers of carers identified increasing. Current services will need to adjust eligibility criteria in order to comply with the new legislation. The Early Help Programme will be key to ensuring children and young people are supported early and in a way that meets their individual needs.

The Care Act 2014 is also expected to be implemented in April 2015 (42). The Care Act 2014 enforces local authorities’ responsibilities for young carers transition to adulthood. This could increase the number of young adult carers accessing support through Adult Social Care. If more young carers and young adult carers are identified then more information can be gathered about the specific needs of young carers in Surrey. Services may need to be delivered in a different way to meet the needs of a higher number of children and young people. However it is not yet known what the financial implications will be. The Adult Social Care document Supporting Carers (43) predicts that if carers have access to support at an early stage there will be a saving due to prevention of health needs escalating. This is due to a high cost of services for both carers and the person they care for if the situation escalates to crisis point.

1650 children and young people are currently supported by Surrey Young Carers (a rise from 1200 three years ago). Adult Social Care made 2% of referrals to Surrey Young Carers in 2012/13 and this increased to 5% in 2013/14. Awareness has been raised throughout 2013 and we would expect this number to rise further (44) (45).

There were 397 CAF/ Early Help Assessments completed overall in 2013/14 (46) which is lower than the previous year. However the expectation is that this number will rise in 2014/5 due to raised awareness of the Early Help Assessment. There will also be a new electronic system for recording Early Help Assessments that will allow the professional completing the assessment to choose “young carer” as a reporting code in the assessment making it easier to identify young carers who are supported through early help.

The Education, Health and Care Plan (EHCP) will replace the SEN statement in September 2014. Surrey County Council has been part of the pilot SEN pathfinder. The Education, Health and Care Plan will begin with an Early Help Assessment. This means that there will be a Team around the Family who can support the young carer if they are caring for a sibling who has an Education, Health and Care Plan or if they themselves have an Education, Health and Care Plan. As the process is started with the Early Help Assessment the child or young person and their family can continue to be supported through the Early Help Offer even if the threshold for the Education Health and Care Plan is not met.
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Evidence based (what works and what does not work)

Family Friends and Community Support (previously called social capital) has been developed in Surrey Adult Social Care in order to improve care packages for adults in Surrey. The project introduces a shift from focus on deficiencies to focus on assets. The vision is to provide community support locally, reducing the cost as well as increasing independence and wellbeing for the person in need of care. Activities from the project include staff awareness workshops, a £6.9 million programme investing in a range of voluntary, charity and faith sector organisations, Time to Change pilot in Redhill, Ageing Well (commitment to promoting the role of older people in communities), Dementia Friendly Surrey and Personalisation, Prevention and Partnership fund (PPP) (47). A 2013 paper published by University of Birmingham and Birmingham City Council cites the work Surrey Adult Social Care are doing building on social capital as an example of good practice (48). It should be noted that improving care packages as part of the Family Friends and Community Support should not mean relying on a young carer or young adult carer to provide an inappropriate level of care.

Joint social care protocols for young carers
In 2009 ADCS and ADASS published a model for councils to use to create a joint memorandum of understanding between directors of Children’s and Safeguarding Service and Adult Social Care. (49) The guidance gives local authorities the tools to clarify thresholds and responsibilities in a document that can be used by all agencies working with young carers. Surrey County Council’s joint protocol, Young Carers Joint Working between Children’s and Adult Social Care, will need to be updated in light of the new legislation. 

Support services for 16 – 24 year olds (50)
Research into Young Adult Carers 16 – 24 in Surrey gives examples of UK projects. Project representatives were interviewed in order to research what works and what doesn’t work for 16 – 24 yr olds. Key themes throughout the projects reviewed in the paper are:

  • It is important to build relationships with colleges and employers in the local area.
  • Building young adult carers support into existing services for young people (eg NEET services) can be a way of supporting young carers to gain skills for independence.
  • Personalised support for each young person is important.
  • Young people should be involved in developing the service in order to offer the best support for the area eg some areas focused on individual support, some on education and employment with others organising social events.
  • It can be difficult to engage 16 – 24 yr olds particularly once they have lost touch with under 18 projects.
  • It takes time to raise awareness and many of the groups started with small numbers. 

Torbay Care Trust – Carers Support Worker Substance Misuse
One example of good practice of joint working cited by The Children’s Society is the implementation of a Carers Support Worker Substance Misuse. The position is employed by the Torbay Care Trust but based in the substance misuse service, COOL recovery. The role increases awareness within substance misuse teams and could provide support for the whole family. The position was part of a new service commissioned for carers and families following a consultation process with carers, users and staff. The worker is able to support all family members including young carers and young adult carers. The service is also available when the cared for person is not in treatment. (51)

Support for young carers in schools (52)
In 2012 Family Action published a report on research undertaken regarding young carers in schools. The key findings include:

  • young carers need to feel supported in school.
  • young carers may not disclose their caring responsibilities due to fear of agencies intervening negatively at home.
  • schools need to work with the whole family to ensure young carers are supported and engaged in education.
  • Family Action delivers young carers services and gives two examples of how their young carers services in Nottingham and Durham work with schools to support young carers and their families in education.

The Bridge Young Carers Durham and Durham County Council Young Carers Charter and ID cards (53)
Key features offered by the service include: 

  • young carers holistic assessment or Family CAF.
  • school development work.
  • young carers forum.
  • awareness raising and education in the community delivered through the County Durham Young Carers Charter. 

Durham County Council Young Carers Charter aims to help schools and other organisations identify young carers and provide support whilst maintaining privacy and confidentiality. It involves mapping actions and progress towards 13 pledges identified by the charter.

The Bridge Young Carers Durham piloted young carer ID cards in schools in 2012. The use of ID cards was introduced in schools that had been awarded the Durham County Council Young Carers Charter. The ID cards are personalised to include any specific support needs the child or young person needs in school. The card re-enforces as recognition for the young carer and is a discreet way of keeping different teachers informed without the young carer having to explain issues like needing a mobile phone on during class or permission to leave early for caring responsibilities.

Key points from the review of the project (54): 

  • Young carers do not want to be seen as different, they just want different support.
  • Involve young carers in the design.
  • Information about the card should be given out in assemblies, displayed on posters and leaflets should be distributed in several areas of the school.
  • Confidentiality and safe sharing of information is important.
  • Information needs to be shared across the school with all teaching staff first.
  • One young carer felt the explanation of the card could have been better “For a young carer it’s kind of hard to explain what it’s for”.
  • Designated leads need to be committed to updating their knowledge about young carers.
  • Partnership and knowledge with local support services ensures young carers get the help they need.
  • One young carer did not like the word “young carer” in big letters on the card and another did not like having their photo on the card. 

Further Research into Young Carer ID Cards
The Welsh government has commissioned Children in Wales to undertake a study during 2014 consulting with young carers regarding young carer ID cards. The information gathered will be used to develop guidelines for local authorities on the use of young carer ID cards. 

Family Mental Health Empowerment Project (55)
Gloucestershire Young Carers and 2gether NHS foundation trust have worked in partnership implementing the project to ensure that no child or young person takes on the majority of the care when an adult is discharged from mental health services.

  • A member of staff from 2gether NHS foundation works as a project worker for the programme splitting time between Gloucestershire Young Carers and the trust’s hospitals, clinics and community mental health teams.
  • Young carers champions and link workers have been identified in all the mental health teams in Gloucestershire.
  • A Web resource has been developed for any professionals working with families impacted by mental health.

Commissioning services
The Carers trust 2012 guidance, Commissioning Services for Young Carers and their Families, outlines 10 headings for good practice in supporting young carers and their families.

  • Whole family approach.
  • Targeted support for young carers and families.
  • Early intervention and prevention.
  • Supporting access to education, employment and training.
  • Improving access to transport for young carers.
  • Improving and maintaining the health and wellbeing of young carers.
  • Transition support: seamless support from young to adult carer.
  • Personalisation: individual budgets and direct payments.
  • Workforce development and raising public awareness.
  • Giving young carers a voice (56)

Value of being a young carer
Young carers are often proud of their role in the family and value their role as carer (57). Although a young carer should not be relied upon for an inappropriate level of care it is important that young carers feel valued and are listened to. Young carer and young adult carer’s views should always be considered in any care package for the person they care for (58).

Making it Real for Young Carers (59)
Young carers in Surrey contributed to the 2012 guidance Making it Real for Young Carers. The guidance is written in the voice of young carers and young adult carers to encourage professionals to listen to young carers’ views in order to understand their needs alongside the needs of the person they care for.

Young carers in schools
The Children’s Society, Carers Trust and Youth Focus have launched a programme working with teachers and school professionals to support young carers while they are at school. Schools who get involved in the project can be awarded the Young Carers’ School Award. (60)

Upcoming work
An audit of cases where young carers are known to children’s social care will be started later this year by the Quality Assurance Team in Children’s and Safeguarding Service. A report will be produced from the audit and may provide more insight into what is working and where there are gaps for young carers.


Unmet needs and service gaps

Young carers who are female and/or from BME groups may be missing out on early help services

Clarification is needed for who will be responsible for the assessment of young carers if the person being cared for is not receiving a statutory service.  The Inter Agency Strategy for young carers will agree any adjustments needed to be ready for the new legislation. The young carers assessment is currently being designed and will be included in the strategy.

Further support is needed during transition to adulthood. Making it real for young carers states “We shouldn’t go from loads of support to nothing when we are 18. It is almost impossible to think about having a life and caring at the same time with nothing” (61)

Children, young people and their families are less likely to contact Surrey Young Carers directly than be referred by another agency. In 2013/14 only 11% of referrals were self referrals or parent referrals. This could mean that further awareness raising is needed to give families the confidence to self refer. However other agencies often refer at the request of the young carer and their family so it may show families feel more confident being referred to the service rather than approaching on their own. This raises the importance of all agencies having the knowledge to identify young carers and make a referral to Surrey Young Carers.

Further identification of young carers caring for someone suffering substance misuse is needed in Surrey. Those caring for someone with substance misuse face barriers in being identified as young carer (62). It is important that all services contribute to the Inter Agency Strategy for Young Carers and agree an updated joint protocol.

There are no current services for young carers aimed at children and young people in the Gypsy Roma Traveller (GRT) communities. There is an action in Surrey’s Strategy for Gypsy Roma and Traveller Children and Young People 2014-17 to improve identification and support for GRT young carers (63).

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Equality Impact Assessment

Hidden from View found young carers are equally as likely to be a boy or girl. This differs from the responses to the Surrey Young Carers Health Survey where 74% of the respondents were female (64). This means that that the information we know from the health survey is swayed from a majority female response. There could be a gap in understanding male young carers’ health needs.

More CAF/Early Help Assessments were completed for males than females in 2013/14 for young carers (65). This means more males than females are currently identified in need of early help. There were no CAF/Early Help Assessments supporting female young carers from BME groups in 2013/14. Female young carers from BME groups may be missing out on support through early help. However it should be noted that only 54 CAF/Early Help Assessments were completed in 2013/14 so the group is not large enough to gain a complete understanding.

Although children and young people in GRT communities can often be expected to assume caring responsibilities (66) there were no CAF/Early Help Assessments completed for young carers from the GRT community in 2013/14. Only one CAF/Early Help Assessment across all needs had GRT as the recorded ethnicity of the child/young person. The number of young carers from GRT communities in Surrey is not known as there can be a barrier in self identification (67). It is not known how many GRT children and young people are supported by Surrey Young Carers.

The 2011 census shows approx 82% of the 0 - 24 year olds in Surrey are white British with the remaining 18% being from BME groups in Surrey (including other white ethnic groups)(68). For more information about ethnicity in Surrey please see the 2011 census data available here.  8.5% of the children and young people receiving a service from Surrey Young Carers were from BME groups in 2012/13 and 11% in 2013/14 (69). Given findings that young carers are 1.5% more likely to be from BME groups there is under-representation in the number of those receiving a service from Surrey Young Carers.
It is important to include young carers and young adult carers when arranging assessments for the people they care for. Making it real for Young Carers (70) advises that assessments and reviews should be booked for a time when the young carer can be present in order for their opinions and views to be included.


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Recommendations for Commissioning

  • The action plan from the Surrey Young Carers Health Survey Report 2013 (71) should be considered by commissioners. The six priorities are: 
  • Carers Breaks. 
  • Health and Wellbeing. 
  • Emotional Support. 
  • Training. 
  • Carers “care” Pathway – Identifying, Recognising and Supporting Young Carers. 
  • Employment Support.

  • Extend existing services to ensure support is available and accessible to all young carers and young adult carers in Surrey.  
     
  • Publish an updated joint protocol on support for young carers between Adult Social Care and Children’s and Safeguarding Service to reflect changes to the Care Act and Children and Families Act with clear pathways that can be accessed and used by any referring agency. 
     
  • Empower schools to identify and support young carers. Consider the use of young carers ID cards and a young carers charter in schools. A recommendation from the Adult Social Care committee in October 2013 is that each school have a governor responsible for supporting young carers. Identification and support for young carers in schools needs to be prioritised by senior management to enable schools to participate in activities identifying and supporting young carers. 
     
  • Support professionals to recognise when a child or young person is a carer. There is currently an e learning package “Young Carers Aware” which is to be updated in the light of legislative change. When the revised version is available this should be widely disseminated to staff in all agencies involved in young carers strategy work. Supporting relevant bodies and increasing staff awareness of carers is a commitment of NHS England by March 2015 (72). 
     
  • Expand on this with guidance for supporting a young carer through the Early Help programme. The Early Help Assessment is a way of all agencies accessing support and recording the work they are doing with the young carer. 
     
  • Young carer champions or specialists are needed, particularly in drug and alcohol services. 
     
  • Raise public awareness so that children, young people and their families recognise when they are a young carer and know where to seek support. 
     
  • Consider if specific services need to be commissioned to ensure young carers emotional wellbeing.
     
  • There is a need to further develop services specifically aimed at 16 – 24 year olds to meet needs in regards to independence, education, employment and transition to adulthood. 
     
  • Improvement in recording support for young carers to aid multi agency working. Creating a record for the young carer is an important step in raising awareness amongst members of staff and viewing the young carers needs in their own right as well as in relation to the needs of the person they care for. 
     
  • Children’s and Safeguarding Service will need to review the current eligibility criteria in regards to the changes which are expected to come into force in April 2015 as a result of changes arising from the Children and Families Act 2014. Draft eligibility regulations from the Care Act 2014 will need to be addressed by Adult Social Care. 
     
  • Carer support payments have been shown as an effective way of supporting young carers and young adult carers and there is scope to further increase the availability of this kind of support. 
     
  • There is a new School Nurse Programme care pathway (73) for young carers. Work should be undertaken with Public Health and NHS providers to ensure effective implementation of this. 
     
  • Commissioners should consider the priorities and commitments listed in NHS England’s Commitment to Carers. One of the commitments is for NHS England to promote the wellbeing of young carers and, in partnership with NHS Improving Quality, hold a national young carers event (74).

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Recommendations for needs assessment work

GP carer payments
It is not known how many young adult carers are accessing GP carer payments as the GP carer payment monthly report does not specify 16 – 24 years old as an age group. However date of birth is recorded so the information could be made accessible.

Numbers of young carers in Surrey
Data is needed regarding the number of young carers known to: 

  • GP surgeries, 0-19 teams and hospitals to show how many individuals receiving a health service are young carers or are receiving support from a young carer.
  • Children’s and Safeguarding Service.
  • schools, colleges and early years settings.

New information recorded by Adult Social Care
Adult Social Care started to create a record for young carers on the Adult Integrated System in 2013. Further analysis is needed to understand more about the young carers identified by Adult Social Care and understand if the need increases when the new legislation comes in.

Children’s and Safeguarding Service
There is currently no accessible data about young carers receiving a targeted or specialist service through Children’s and Safeguarding Service. It should be considered how the Integrated Children’s System can be used to collect data about the needs of young carers in Surrey.

BME Groups
Further information is needed regarding the needs of young carers from BME groups in Surrey. Currently we are only able to see the data from Surrey Young Carers and Early Help which shows that there may be a gap in children from BME groups receiving support.


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Key contacts

Jane Keenan, Surrey County Council. jane.keenan@surreycc.gov.uk
John Bangs, Surrey County Council. john.bangs@surreycc.gov.uk
Sheila Jones, Surrey County Council. sheila.jones@surreycc.gov.uk
Jane Thornton, Action for Carers. jane.thornton@actionforcarers.org.uk
Debbie Hustings, NHS Guildford and Waverley, East Surrey and Surrey Downs Clinical Commissioning Groups.debbie.hustings@nhs.net
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Chapter References

1. ADASS, ADCS and The Children’s Society (2012) Working Together to Support Young Carers and their Families. Available at: http://www.youngcarer.com/sites/default/files/imce_user_files/PTP/mou_young_carers_2012.pdf Accessed on 03/02/2014
2. Action for Carers Surrey (2012) Research into Young Adult Carers Aged 16­24 in Surrey. Available at: https://www.actionforcarers.org.uk/files/7613/6329/2930/Full_Report-into-Young_Adult_Carers_in_Surrey_16-24_1.pdf Accessed on 03/02/2014
3. NHS Guildford and Waverley Commissioning Group and Surrey Young Carers (2013) Surrey Young Carers Health Survey Report 2013 Available at: http://carersworldradio.ihoststudio.com/carersnet/surrey%20young%20carers2.pdf Accessed on 07/02/2014
4. HM Government (2014) Children and Families Act 14 Part 5. Available at: http://www.legislation.gov.uk/ukpga/2014/6/contents/enacted
Accessed on 24/04/2014
5. HM Government (2014) Care Act Part 1. Available at: http://www.legislation.gov.uk/ukpga/2014/23/contents/enacted/data.htm Accessed on 04/06/2014
6. Surrey County Council (2011) The Interagency Strategy for Young Carers in Surrey 2011 – 2014 available at: http://carersworldradio.ihoststudio.com/useful/SURREY%20YOUNG%20CARERS%201st%20part%20colour%20'10.pdf Accessed on 07/02/2014
7. NHS Guildford and Waverley Commissioning Group and Surrey Young Carers (2013) Surrey Young Carers Health Survey Report 2013 Available at: http://carersworldradio.ihoststudio.com/carersnet/surrey%20young%20carers2.pdf Accessed on 07/02/2014
8. ADASS and ADCS (2011) Signposts: Working together to improve outcomes for young carers in families affected by enduring parental mental illness or substance misuse
Available at:
http://www.adcs.org.uk/download/news/signposts.pdf Accessed on 12/02/2014
9. The Children’s Society (2011) Supporting children who have a parent with a mental illness Available at: http://www.youngcarer.com/sites/default/files/mental_illness_booklet_2011_2nd.pdf Accessed on 16/05/2014
10. Social Care Institute for Excellence (2005) The Health and Wellbeing of Young Carers Available at: http://www.scie.org.uk/publications/briefings/files/briefing11.pdf Accessed on: 19/05/2014
11. Royal College of General Practitioners (2014) Commissioning for Carers 2013 Available at: http://www.rcgp.org.uk/clinical-and-research/clinical-resources/~/media/Files/CIRC/Carers/RCGP-Commissioning-for-Carers-2013.ashx Accessed on 13/05/2014
12. HM Government (2014) Healthy lives Healthy People Available at:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216096/dh_127424.pdf Accessed on 19/05/2014
13. University of Nottingham and Commission for Rural Communities (2008) Service needs and delivery following the onset of caring amongst children and young adults: evidence based review Available at: http://saulbecker.co.uk/v1/downloads/young_carers/Evidence%20review%20on%20young%20carers%20and%20young%20adult%20carers%202008.pdf
Accessed on 07/04/2014
14. Carers Trust and A&BS Charitable Fund (2012) Commissioning Services for Young Carers and their Families
Available at: http://www.carers.org/sites/default/files/commissioning_services_for_young_carers_and_their_familes_final_copy_for_web.pdf Accessed on 12/02/2014 Accessed on 12/02/2014
15. Action for Carers Surrey (2012) Research into Young Adult Carers Aged 16­24 in Surrey. Surrey: Action for Carers. Available at: 
https://www.actionforcarers.org.uk/files/7613/6329/2930/Full_Report-into-Young_Adult_Carers_in_Surrey_16-24_1.pdf Accessed on 03/02/2014
16. The Children’s Society (2013) Hidden from view: The experiences of young carers in England Available at:
http://www.childrenssociety.org.uk/sites/default/files/tcs/report_hidden-from-view_young-carers_final.pdf Accessed on 13/02/2014
17. Ibid
18. Race Equality Foundation and Communities and Local Government (2008) The Health of Gypsies and Travellers in the UK Available at: http://www.better-health.org.uk/sites/default/files/briefings/downloads/health-brief12.pdf Accessed on 23/04/2014
19. The Children’s Society (2013) Hidden from view: The experiences of young carers in England Available at: 
http://www.childrenssociety.org.uk/sites/default/files/tcs/report_hidden-from-view_young-carers_final.pdf Accessed on 13/02/2014
20. Becker, University of Nottingham (2007) Global Perspectives on Children’s Unpaid Caregiving in the Family Available at:
http://saulbecker.co.uk/v1/downloads/young_carers/S%20Becker%20Global%20perspectives%20on%20young%20carers.pdf
Accessed on: 09/04/2014
21. University of Nottingham and Commission for Rural Communities (2008) Service needs and delivery following the onset of caring amongst children and young adults: evidence based review Available at: http://saulbecker.co.uk/v1/downloads/young_carers/Evidence%20review%20on%20young%20carers%20and%20young%20adult%20carers%202008.pdf
Accessed on: 07/04/2014
22. The Children’s Society (2013) Hidden from view: The experiences of young carers in England Available at:
http://www.childrenssociety.org.uk/sites/default/files/tcs/report_hidden-from-view_young-carers_final.pdf Accessed on 13/02/2014
23. Carers Trust and The University of Nottingham (2014) Young Adult Carers and Employment Available at: http://www.carers.org/sites/default/files/young_adult_carers_and_employmentlo_final_2.pdf Accessed on 19/05/2014
24. Surrey County Council (2013) JSNA Chapter: Carers Available at: https://www.surreyi.gov.uk/GroupPage.aspx?GroupID=36 Accessed on 29/04/2014
25. NHS Guildford and Waverley Commissioning Group and Surrey Young Carers (2013) Surrey Young Carers Health Survey Report 2013 Available at: http://carersworldradio.ihoststudio.com/carersnet/surrey%20young%20carers2.pdf Accessed on 07/02/2014
26. ADASS and ADCS (2011) Working Together to Support Young Carers and their Families: A Template for a Local Memorandum of Understanding [MoU] between Statutory Directors for Children’s Services and Adult Social Services Available at: http://www.youngcarer.com/sites/default/files/imce_user_files/PTP/mou_young_carers_2012.pdf Accessed on 17/04/2014
27. Surrey Children’s and Safeguarding Service (2014) Early Help Data 2013/14 Surrey: Surrey County Council
28. Surrey Children’s and Safeguarding Service (2014) Early Help Multi-Agency Level of Needs Guidance Available at: http://www.surreycc.gov.uk/__data/assets/pdf_file/0008/803906/Early-Help-multi-agency-levels-of-need-document-March-2014.pdf Accessed on 04/06/2014
29. Surrey Adult Social Care (2013) Number of Young Carers currently open on Adults Integrated System (AIS) Surrey: Surrey County Council
30. Surrey Adult Social Care (2013) Number of GP Carer Payments each month in 2013/14 for Primary Client Groups Surrey: Surrey County Council
31. NHS England (2014) NHS England’s Commitment to Carers Available at: http://www.england.nhs.uk/wp-content/uploads/2014/05/commitment-to-carers-may14.pdf Accessed on 14/05/2014
32. Adult Social Care (2014) Young Carer Payments dataset Surrey: Surrey County Council
33. NHS Guildford and Waverley Commissioning Group and Surrey Young Carers (2013) Surrey Young Carers Health Survey Report 2013 Available at: http://carersworldradio.ihoststudio.com/carersnet/surrey%20young%20carers2.pdf Accessed on 07/02/2014
34. Surrey County Council (2011) The Interagency Strategy for Young Carers in Surrey 2011 – 2014 available at: http://carersworldradio.ihoststudio.com/useful/SURREY%20YOUNG%20CARERS%201st%20part%20colour%20'10.pdf Accessed on 07/02/2014
35. Royal College of General Practitioners (2013) RCGP Supporting Carers in General Practice Available at: http://www.rcgp.org.uk/clinical-and-research/clinical-resources/~/media/Files/CIRC/Carers/RCGP-GP-practice-journeys-improved-carer-id-and-support-Oct-13.ashx Accessed on 14/05/2014
36. Action for Carers (2013) Be Informed Available at: http://www.actionforcarers.org.uk/files/5613/7024/8647/PRINT_DOWNLOAD_BE_INFORMED.pdf Accessed on 23/04/2014
37. Surrey County Council (2014) Family Support Programme Business Case Available at:http://mycouncil.surreycc.gov.uk/mgConvert2PDF.aspx?ID=11346 Accessed on 07/05/2014
38. Services for Young People (2012) The Young People’s Employability Plan 2012 – 2017 Available at: http://www.surreycc.gov.uk/__data/assets/pdf_file/0006/395655/Employability-plan-summary-FINAL.pdf Accessed on 03/06/2014
39. Services for Young People (2014) Surrey Young People’s Outcomes Framework Available at: http://mycouncil.surreycc.gov.uk/documents/s13387/item%2007%20-%20Creating%20Opportunities%20for%20YP.pdf Accessed on 03/06/2014
40. Adult Social Care, Surrey County Council (2013) Supporting Carers
Available at:
http://mycouncil.surreycc.gov.uk/documents/s9243/ASC%20Select%20Committee%20Carers%20Report%20-%20October%202013.pdf Accessed on 03/03/2014
41. HM Government (2014) Children and Families Act 14 Part 5. Available at: http://www.legislation.gov.uk/ukpga/2014/6/contents/enacted
Accessed on 16/04/2014
42. HM Government (2014) Care Act Part 1. Available at: http://www.legislation.gov.uk/ukpga/2014/23/contents/enacted/data.htm Accessed on 04/06/2014
43. Adult Social Care, Surrey County Council (2013) Supporting Carers
Available at:
http://mycouncil.surreycc.gov.uk/documents/s9243/ASC%20Select%20Committee%20Carers%20Report%20-%20October%202013.pdf Accessed on 03/03/2014
44. Action for Carers (2013) Surrey Young Carers Activity Data 2012/13 Surrey: Action for Carers
45. Action for Carers (2013) Surrey Young Carers Activity Data 2013/14 Surrey: Action for Carers
46. Children’s and Safeguarding Service (2014) CAF/Early Help data 2012/13 Surrey: Surrey County Council
47. Adult Social Care (2013) Family, Friends and Community Support Social Capital in Surrey Available at: http://mycouncil.surreycc.gov.uk/documents/s9237/Adult%20Social%20Care%20Select%20Committee%20-Social%20Capital%20in%20Surrey.pdf
Accessed on 27/03/2014
48. University of Birmingham and Birmingham City Council (2013) Turning the welfare state upside down?’ Developing a new adult social care offer Available at: http://www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/HSMC/publications/PolicyPapers/policy-paper-fifteen.pdf Accessed on 29/05/2014
49. ADASS and ADCS (2011) Working Together to Support Young Carers and their Families: A Template for a Local Memorandum of Understanding [MoU] between Statutory Directors for Children’s Services and Adult Social Services Available at: http://www.youngcarer.com/sites/default/files/imce_user_files/PTP/mou_young_carers_2012.pdf Accessed on 17/04/2014
50. Action for Carers (2012) Research into Young Adult Carers Aged 16­24 in Surrey. Available at:
https://www.actionforcarers.org.uk/files/7613/6329/2930/Full_Report-into-Young_Adult_Carers_in_Surrey_16-24_1.pdf Accessed on 03/02/2014
51. The Children’s Society (2014) Prevention through Partnership Practice Examples Available at: http://www.youngcarer.com/sites/default/files/imce_user_files/PTP/Resource_Bank/Good_Examples/carers_support_worker_substance_misuse.pdf Accessed on 01/04/2014
52. Family Action (2013) Be Bothered! Making Education Count for Young Carers Available at: http://www.family-action.org.uk/uploads/documents/Be%20Bothered!%20Make%20Education%20Count%20for%20Young%20Carers.pdf Accessed on 23/04/2014
53. Ibid
54. Family Action (2013) An evaluation of the work implemented by Family Action The Bridge Young Carers in supporting and delivering the Young Carer’s School Card within schools in County Durham Durham: Family Action
55. Carers Trust (2013) Practice example Whole-family support for young carers affected by parental ill health Available at: http://static.carers.org/files/whole-family-support-for-young-carers-affected-by-parental-mental-ill-health-6661.pdf Accessed on 16/05/2014
56. Carers Trust (2012) Commissioning Services for Young Carers and their Families Available at: http://www.waterloofoundation.org.uk/Files/commissioning_services_for_young_carers_and_their_familes_final_copy_for_web.pdf Accessed on 22/04/2014
57. ADASS and ADCS (2011) Working Together to Support Young Carers and their Families: A Template for a Local Memorandum of Understanding [MoU] between Statutory Directors for Children’s Services and Adult Social Services Available at: http://www.youngcarer.com/sites/default/files/imce_user_files/PTP/mou_young_carers_2012.pdf Accessed on 17/04/2014
58. Think Local Act Personal (2012) Making it Real for Young Carers Available at: http://www.thinklocalactpersonal.org.uk/_library/MIRyoungcarersFINAL.pdf Accessed on 03/02/2014
59.Ibid
60. The Children’s Society (2014) Young Carers in Schools Available at: http://www.youngcarer.com/resources/ycif/young-carers-schools Accessed on 05/06/2014
61. Think Local Act Personal (2012) Making it Real for Young Carers Available at: http://www.thinklocalactpersonal.org.uk/_library/MIRyoungcarersFINAL.pdf Accessed on 03/02/2014
62. ADASS and ADCS (2011) Signposts Available at: http://www.adcs.org.uk/download/news/signposts.pdf Accessed on: 23/04/2014
63. Surrey County Council (2014) Surrey’s Strategy for Gypsy Roma and Traveller Children and Young People 2014-17 Surrey: Surrey County Council
64. The Children’s Society (2013) Hidden from view: The experiences of young carers in England Available at:
http://www.childrenssociety.org.uk/sites/default/files/tcs/report_hidden-from-view_young-carers_final.pdf Accessed on 13/02/2014
65. Children’s and Safeguarding Service (2014) CAF/Early Help data 2012/13 Surrey: Surrey County Council
66. Surrey County Council (2014) Needs analysis for Surrey’s Gypsy, Roma and Traveller children and young people 2013 Surrey: Surrey County Council
67. Ibid
68. Surreyi (2014) Dataset: Census 2011: Ethnic group by age Available at: https://www.surreyi.gov.uk/Viewdata.aspx?P=Data&referer=%2fViewpage.aspx%3fC%3dbasket%26BasketID%3d224 Accessed on 11/04/2014
69. Action for Carers (2013) Surrey Young Carers Activity Data 2012/13 and 2013/14 Surrey: Action for Carers
70. Think Local Act Personal (2012) Making it Real for Young Carers Available at: http://www.thinklocalactpersonal.org.uk/_library/MIRyoungcarersFINAL.pdf Accessed on 03/02/2014
71. NHS Guildford and Waverley Commissioning Group and Surrey Young Carers (2013) Surrey Young Carers Health Survey Report 2013 Available at: http://carersworldradio.ihoststudio.com/carersnet/surrey%20young%20carers2.pdf Accessed on 07/02/2014
72. NHS England (2014) NHS England’s Commitment to Carers Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/299270/Young_Carers_pathway_Interactive_FINAL.pdf Accessed on: 15/05/2014
73. Department of Health (2014) Supporting the health and wellbeing of young carers Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/299270/Young_Carers_pathway_Interactive_FINAL.pdf Accessed on 01/05/2014
74. NHS England (2014) NHS England’s Commitment to Carers Available at: http://www.england.nhs.uk/wp-content/uploads/2014/05/commitment-to-carers-may14.pdf Accessed on: 15/05/2014 
 
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Signed off by

John Bangs, Surrey County Council
Debbie Hustings, NHS Guildford and Waverley, East Surrey and Surrey Downs Clinical Commissioning Groups
Sheila Jones, Surrey County Council
Jane Thornton, Action for Carers

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Updated: 27 March 2017 | Owner: Tricia Boahene
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