It is important that primary care teams are aware of the problems that carers face, and practices are organised to identify carers, involve them in patient care where appropriate, and support them to maintain the caregiving situation.

The key to change is the development of a whole-family approach and for all agencies – including children’s and adult’s services – to work together to offer coordinated assessments and services to the child and the whole family. There may be differences of view between children and parents about what constitutes appropriate levels of care, and these may be out in the open or concealed. Resolution requires a whole-family approach and good partnership working.