An Open Letter to Baroness Casey:

15 minutes ago

4 min read

The Overlooked Unpaid Carers of Injured Veterans

Dear Baroness Casey,

I listened with considerable interest to your contribution on BBC Radio 4 – Today concerning the future of adult social care and the work of your Commission.

I am writing as Chief Executive of The Ripple Pond, a national charity supporting the families of physically and psychologically injured members of the British Armed Forces and veterans.

I believe our experience offers an important insight into a wider issue at the heart of your

Commission’s work: the extent to which our health and care systems depend upon unpaid

family carers, often without adequately recognising, supporting or protecting them.

Behind many injured veterans is a partner, parent or other family member providing years,

sometimes decades, of unpaid care. For those supporting someone with PTSD or other

psychological injuries, that care may be less visible than traditional caring responsibilities. It

can involve managing crises, supporting treatment and recovery, maintaining family stability,

protecting children and navigating an often bewildering range of services.

These families are an enormous but largely unrecognised resource. Too often, their contribution is simply assumed, rather than properly understood or supported.

The Ripple Pond currently supports approximately 1,300 family members across the UK, and we believe we are only scratching the surface of the need.

Much of our work involves supporting families who have struggled to find help within services primarily designed around the needs of the injured veteran. We regularly receive referrals and enquiries from NHS services, including Op COURAGE, Defence Medical Services, military charities and other organisations. Often, the professionals involved recognise that family members need support, but struggle to meet their particular needs.

This is not a criticism of those services. Many work closely with us and are doing their best to

support families. Rather, it illustrates a wider problem: we have developed systems to treat and support the injured individual, but have not always given the same consideration to those upon whom their care and recovery so often depend.

There is also a strong practical argument for doing things differently. Supporting the family is not simply about meeting an additional set of needs. When the needs of the patient and their family are considered together, services have a better opportunity to coordinate care, support recovery, prevent problems escalating and reduce avoidable demands on health and social care. It can also help families maintain their own wellbeing, relationships and independence.

Recognising and supporting family carers should not be seen simply as an additional cost.

Done well, it offers the potential for better outcomes for the injured person and their

family, more effective use of resources and greater value for the public money already

being spent.

Our experience also reveals a more troubling dimension to the lives of some of these unpaid

carers.

An examination of our membership records for those joining since November 2023 found that more than one in five had been identified as Members of Concern, either currently or

previously. These are family members for whom we have identified serious or growing risks to their safety or wellbeing, including domestic abuse, suicidal ideation, significant mental health difficulties, financial crisis and safeguarding concerns involving children.

Within the same group, almost one in seven had a recorded domestic abuse concern.

Importantly, these figures do not represent the true prevalence of domestic abuse or other

serious difficulties among military families. They reflect only those concerns that have come to our attention and been recorded. We know that much remains hidden, particularly where

families are reluctant to disclose difficulties involving someone they love and care for.

Indeed, our wider casework experience shows that approximately one-third of serious concerns are only disclosed after more than twelve months of engagement, once sufficient trust has developed for someone to speak openly about what is happening at home.

This raises a question that I believe extends well beyond the military community:

How many unpaid carers are themselves living with significant harm or risk, while

remaining largely invisible to the health and care services that depend upon their

contribution?

The consequences can be profound, affecting mental health, financial security, employment,

relationships and the wellbeing of children. Yet the support available to the injured person does not necessarily extend to the family member who may be holding everything together.

I appreciate that the particular circumstances of military families may not always sit neatly

within conventional adult social care arrangements. Nor do I suggest that military families

should be treated as a separate category within social care reform. Rather, I believe their

experiences illustrate some fundamental challenges in how we understand caring, recognise its consequences and share responsibility for supporting those who provide it.

I would welcome the opportunity to share our evidence and experience with your Commission, particularly concerning hidden caring responsibilities, the risks faced by family members and the importance of sustained support that extends beyond the period of clinical treatment.

Above all, I hope that as we consider the future of adult social care, we do not overlook those whose contribution is so easily taken for granted, simply because they are family.

Thank you for your work in bringing these difficult issues into the national conversation.