Juggling nursing and carer roles with the help of colleagues

How a staff network set up by a nurse with caring responsibilities offers support and resources for members, and wider recognition of the challenges they face

  • The working carers support group offers a ‘safe space’ for members, advice from trusted sources and a break from pressures, and has expanded to other organisations
  • Nurse Joanne Shaw, who set up the group, was recognised with the Commitment to Carers Award at the RCN Nursing Awards 2021
  • Tips for how to set up a working carers support group at your workplace
Joanne Shaw, right, with one of the working carers in the staff support group she set up

Nurse Joanne Shaw is an informal carer for her seven-year-old son, who has autism.

Her experience juggling caring responsibilities with a nursing career has been challenging, but is far from unusual.

Many people may not realise they are informal carers

‘Being a carer after my son was born was a new thing for me,’ recalls Ms Shaw, head of nursing for clinical services and safeguarding at Liverpool Heart and Chest Hospital NHS Foundation Trust. ‘My older children were going through mainstream schooling, and I was trying to cope with managing my work at a high level.’

A 2020 Nursing Standard survey revealed that one in seven of the 2,150 respondents had taken carer’s leave in the previous 12 months to look after a dependent.

And the latest NHS staff survey in England found one in three NHS employees, about 400,000 staff in total, have an unpaid caring role for a relative or friend.

2.8 million

working people in the UK took on a new caring role for a loved one during the early stages of the pandemic

Source: Carers Week 2020 Research Report

But the proportion of nurses and other healthcare staff who also have caring responsibilities could be higher still because many may not even realise they are informal carers. Indeed, it takes an average of two years for a carer to acknowledge their role, according to NHS England.

Support group for staff who are also carers

Determined to help others with a shared experience, in 2018 Ms Shaw set up a support group for staff at her trust who have caring responsibilities.

The need for support was evident from the outset, with an initial staff email about the group attracting 100 responses.

‘Caring can be extremely demanding and tiring, and talking to someone in a similar situation can help,’ says Ms Shaw. ‘It is difficult coping with that role while working as well.

‘Some people were going through a similar situation to me – either with young children who had been recently diagnosed with a learning disability, or young people moving into different care situations. Many others were caring for older family members.

‘I was open about what was happening with my son so people would come and talk to me about their own care experiences.’

‘A lot of caring goes on behind closed doors and until we set up the group a lot of our staff felt very isolated and alone with this element of their home life’

Joanne Shaw, head of nursing for clinical services and safeguarding, Liverpool Heart and Chest Hospital NHS Foundation Trust

The support group meets once at month at lunchtime, with lunch provided through sponsorship from supermarkets and food outlets. As well as offering a chance to meet with colleagues facing similar challenges, the group invites guest speakers from charities and local services. Topics have included include caring for a child with an illness or long-term disability, coping strategies and caring for an older relative.

Identifying and supporting staff who are carers can help to prevent sickness absence and improve retention, say Ms Shaw Picture:

Lack of awareness of carer numbers

At the same time Ms Shaw set up her group, her trust was looking for ways to improve engagement with its staff networks. The trust wanted to gauge how many staff had caring responsibilities, so another email went out to all trust staff inviting them to register as informal carers if that was the case.

‘We could look at the data on carers in the north west to estimate how many carers we had, but not really know how many carers were on our teams,’ Ms Shaw says. ‘I was gobsmacked at how many people were.’

‘Before the support group, I wasn’t registered as a carer’

Claire Harvey is matron for the medical division at Liverpool Heart and Chest Hospital. Here, she describes the impact the carers support group has had on her life:

Claire Harvey: ‘Without the support group, staff may struggle to know where to turn to’

‘My oldest daughter, who is 14, has severe learning disabilities, autism and attention deficit hyperactivity disorder. It has been very difficult to manage caring alongside my work.

‘The carers support group has made a real difference. Before the support group, I wasn’t registered as a carer and was unaware of the support available to me locally.

‘We get together every month – it’s only an hour out of our day but it is an opportunity to talk and share our experiences. Often there are colleagues going through similar challenges and we are able to give each other advice.

A way to share experiences, knowledge and activities

‘The support carries on outside the group; I have been able to share my experience and knowledge of the education system, which has enabled colleagues to obtain the appropriate support for their children.

‘When you have a child with special needs, navigating the system is very difficult and without the support group, staff may struggle to know where to turn to for support.

‘We can also share opportunities and activities available for children with disabilities, such as autism-friendly sessions at a local trampolining park.

‘HR colleagues also visit the group and hear about our experiences and the group has raised awareness among senior managers about the challenges faced by unpaid carers – and the additional responsibilities they have at home. All the senior managers have been very supportive.

‘This has made it easier for staff to access support such as flexible working opportunities.’

Self-care and well-being priorities

1 in 3

NHS employees in England – about 400,000 staff in total – have an unpaid caring role for a relative or friend

Source: NHS Staff Survey

Another crucial area of focus for the group is how carers can look after themselves while juggling work and home responsibilities.

‘When you are a carer you spend a lot of time focusing on someone else, but it’s important you think about your own well-being,’ says Ms Shaw.

She says caring should be considered as one of the social determinants of health, defined by the World Health Organization as the non-medical factors that influence health outcomes. These include education, working conditions and social inclusion.

Unpaid carers who provide high levels of care for ill or disabled relatives and friends are more than twice as likely to experience poor health, compared with people without caring responsibilities, according to NHS England.

‘Our staff survey shows people feel supported and we do not see the stress of caring responsibilities given as a reason for staff leaving our trust’

Ms Shaw

‘A lot of caring goes on behind closed doors and until we set up the group a lot of our staff felt very isolated and alone with this element of their home life,’ says Ms Shaw.

‘But the initiative has grown. It is about the health and well-being of our staff. Now staff throughout the trust are really informed about caring and the impact it has. We look at our policies and procedures and see where decisions will affect our staff who are also informal carers.’

Recognition and uptake of the initiative beyond the trust

The group has now expanded beyond the trust, and is open to staff at nearby Merseyside Care NHS Foundation Trust and the Liverpool University Hospitals NHS Foundation Trust.

For her work on the initiative, Ms Shaw won the RCN Nursing Awards 2021 Commitment to Carers category, sponsored by NHS England.

She says winning the award has provided a great opportunity to share best practice and ‘hopefully encourage and inspire others to run similar groups in their area of work’.

Tips for how to start a carers support group where you work

The support group has brought more recognition across the trust for the challenges faced by working carers, says Joanne Shaw, centre Picture:

Starting and running the carers support group didn’t involve a lot of investment in terms of time or money, says nurse Joanne Shaw, but colleagues have given feedback on what a difference it has made.

If every workplace had a similar group we would see real change across the NHS, she says. Here are her tips for setting up a group at your workplace:

  • Find out how many members of staff are carers and who they are. We have a staff register of carers. It is important to really understand your local data
  • Think about the social determinants of health For example, the number of staff who will have older people dependent on them in the near future
  • Find a suitable venue Face-to-face meetings have worked better for us. Group members sometimes come in with their children if the group meeting falls on their day off
  • Make your case to managers on the benefits of allowing staff to have the time out to attend a meeting for just one hour a month. A high proportion of our staff are in the 45-64 age bracket and very experienced; losing due to the combined pressures of work and caring roles would have a real impact on our organisation
  • Put on refreshments and food We offer a free lunch by working with sponsors in the community, including Sainsbury’s, Pizza Hut and Subway.
  • Work with local groups to support your teams We invite keynote speakers from organisations such as carers’ centres and the Alzheimer’s Society
  • Make resources easily accessible We share a lot of resources on Sharepoint that staff can access once they register as a carer

The benefits of supporting carers in the workforce

Ms Shaw says making carers more visible in the workforce helps with sickness absence, and supports carers to attend appointments.

1 in 7

nurses who responded to Nursing Standard’s 2020 health and well-being at work survey had to take carer's leave in the previous 12 months to look after a dependant

Source: Nursing Standard – Nursing at work, caring at home: advice, tips and your workplace rights

‘It is enabling them to attend appointments with a young child, for example, and making it easier for them to access the support they need.

‘When my child was diagnosed I was offered a six-week training programme to learn about autism, but there was no way I would be able to attend, so my mum had to go instead.’

The pandemic has also affected carers, and the group has adapted to ensure members are supported.

‘COVID has had a huge impact, with schools closing and one-to-one carers not being available. We are having a lot more video meetings with staff members who are really struggling at home.’

Senior managers have been supportive and can see the benefits of supporting carers in the workforce, says Ms Shaw.

‘Supporting staff who are carers is good for retention. Often carers are our most experienced staff and we do not want to lose them. Our staff survey shows people feel supported and we do not see the stress of caring responsibilities given as a reason for staff leaving our trust.’

Liverpool Heart and Chest Hospital NHS Foundation Trust diretor of nursing, safety and quality Sue Pemberton says the group has been ‘an invaluable place where staff come along and find mutual support and encouragement’.

‘It is a safe space to share with others in similar situations,’ she says. ‘This supports the trust’s vision of inclusivity and caring for our staff and has been hugely appreciated by many of our team when they’ve needed it most.’

Visit our free well-being centre

Ms Shaw adds: ‘Carers often go unrecognised but if we can support, guide and care for our staff they in turn will be there for our patients.

‘This initiative is really easy to implement and I hope all trusts show they have a commitment to carers.’

A network that ensures no staff with caring responsibilities are left alone

Joanne Shaw won the NHS England-sponsored Commitment to Carers category of the RCN Nursing Awards 2021.

NHS England experience of care lead, community, primary and integrated care, Jen Kenward says: ‘Every entry for the award demonstrated a meaningful way of working compassionately and purposefully to improve how unpaid carers are identified and supported.

‘The pandemic has seen the challenges faced by unpaid carers magnified as services have changed, and many carers have felt isolated. During this time the number of unpaid carers has risen dramatically.

‘The judges were really struck by Ms Shaw’s insight into the challenges experienced by unpaid carers and her compassion and drive to support colleagues juggling work and a caring role.

Joanne Shaw, winner of the Commitment to Carers Award at the RCN Nursing Awards 2021

‘She has developed a support network that ensures no staff with caring responsibilities are left alone, they know where to access support and have a safe space to share their concerns. Her passion and drive for this work is just exceptional.’

Chair of judges and Foundation of Nursing Studies chief executive Joanne Bosanquet praised Ms Shaw’s insight into the importance of social determinants in unpaid carers’ health and well-being.

‘She stunned the panel with her use of data and evidence to demonstrate the need to focus on carers in the workplace. Ms Shaw is a highly visible and strong leader and advocate for equality and diversity at work.’

Further information

NHS Staff Survey 2020 results

Carers UK