External Review of the National Carer Organisations (NCOs)

Annex 2: The National Carer Organisations

Detailed information was gathered about the individual NCOs, which provides additional contextual information. While it should be stressed that the review did not involve an evaluation of these organisations, this annex describes their structure and operation in the following areas:

• Legal status.
• Management, structure, staffing and membership.
• Aims, objectives and areas of work.
• Funding.

The material has been developed from documents provided to the research team by each of the NCOs. By necessity, the summaries are brief, and cover only the main strands of the work of the NCOs. The findings were current at the time of writing the report (June 2014).

The NCOs represent a diverse group. Each has its own aims and objectives. Some are, in the context of the voluntary sector, relatively large, while others are small. Some deliver services, while others do not. However, it is worth noting at the outset that all of the NCOs avowedly share a common purpose. Each has, at an individual level, adopted the outcomes in Caring Together, and set these alongside their individual aims, objectives and outcomes.

Legal status

In terms of their legal status, six of the seven NCOs are Scottish charities. The exception to this is the Alliance (which is hosted by Carers Trust Scotland). The Coalition, which is an unincorporated association but also a Scottish charity, is hosted by VOCAL.

Two of the NCOs are part of larger UK organisations (although they are also Scottish charities). Carers Scotland is part of Carers UK, and the Carers Trust Scotland is part of the Carers Trust. The relationship between these Scottish charities and their UK parent organisations will be explored in more detail later.

Management, structure, staffing and membership

The management, structure, staffing and membership of each of the NCOs will be examined in turn. As will become clear, there is some consistency across the NCOs in most of these areas.

The four "freestanding" Scottish-based NCOs each has a Board, while the two UK organisations have a Scotland-specific Committee with representation at national Board level. The Alliance is slightly different in having a Management Committee.

With the exception of Crossroads, which has a number of local branches, each of the NCOs has a simple structure, with a single national base. Both Crossroads and MECOPP have staff dedicated to direct service delivery to carers, although in both cases, the NCO Network function is limited to part of the time of the Chief Executive. Among the remaining NCOs, the largest has 11.7 full-time equivalent staff, the smallest (the Coalition) has only one.

The Carers Trust and Crossroads both operate affiliation programmes, where services are provided to partners on payment of an agreed fee. The others operate membership schemes of various kinds, both for individuals and organisations.

Carers Scotland

The Carers UK Board has overall responsibility for operations in Scotland. It comprises 18 trustees, the majority of whom are carers or former carers. The Scotland Committee is nominally a sub-group of the UK Board. It is comprised of a maximum of 18 members, and all of the current members are either current or former carers. Up to a third of the Scotland Committee members can be co-opted in order to provide specific expertise. The Scotland Committee nominates a member to sit on the UK Board. Carers UK is a company limited by guarantee, and Carers Scotland is a Scottish charity.

Although the overall direction of Carers Scotland rests with Carers UK, in practice it has a significant amount of autonomy in terms of its overall direction. As will be noted later in relation to its work, Carers Scotland has chosen to focus on a number of areas which are led at a UK level by Carers UK, but this appears to have been by choice, rather than by direction.

At the time of the review, Carers Scotland had seven staff based in Scotland ^[18] . Six of these were based in Govan in Glasgow. The final worker was based within an Advocacy project covering parts of the south side of Glasgow.

Carers Scotland operates differing membership schemes for individuals and for organisations. There is a two-tier system in place for individual members. "Full" members pay a minimum donation and have access to all services of Carers Scotland. "Standard" members do not pay anything, and receive information by e-mail. As at January 1, 2014, Carers Scotland had 264 full members and 691 standard members.

Carers Scotland also operates an affiliate membership scheme for organisations. This entitles members to receive policy updates, but does not provide any voting rights. At January 1, 2014, Carers Scotland had 33 affiliate members (including other NCOs).

Carers Trust Scotland

Carers Trust Scotland is part of the Carers Trust, which is a private company limited by guarantee (while Carers Trust Scotland is a Scottish charity). The Carers Trust was created at a UK level in 2012, bringing together the former Princess Royal Trust for Carers and Crossroads. In Scotland, the respective organisations chose not to merge.

The Carers Trust Board at a UK level has up to eleven Trustees, one of whom is a network representative from Scotland. There is also a UK Partnership forum, with two Scottish representatives. At a local level in Scotland, direction is provided by the Scotland Committee, which is comprised of representatives of the Managers Network (3); the Trustees Network (3); a member of the UK Board; Carers Trust staff and up to 3 co-opted places.

The Carers Trust in Scotland has 11.7 full-time equivalent staff, including 3.5 full-time equivalent staff funded by the Scottish Government to work on Alliance projects.

The Carers Trust provides a variety of support to affiliated member Carer Centres (referred to as "Network Partners") on the basis of a flat fee. Currently, 21 Carer Centres have affiliated for 2014-15, a reduction of 4 on the previous year. The Managers' Network meets quarterly and comprises all affiliated Carer Centre managers.

Coalition of Carers in Scotland

The Coalition of Carers in Scotland is an unincorporated association. It was established in 1998, and became registered as a Scottish charity in 2008.

The work of the Coalition is directed by an Executive Committee, comprised of carers, former carers, staff and former staff of carer organisations around Scotland. The members of the Executive Committee are elected at the AGM.

The Coalition has one full-time member of staff. Since the establishment of that post, one Carer Centre (currently VOCAL) has acted as employer and responsible organisation for the staff member, in terms of both receiving and disbursing funding. The work of the Coalition is supported both by Executive Committee members and staff from member organisations who donate time to take forward projects under the banner of the Coalition.

As at January 1, 2014, the Coalition had 107 organisational members, including Carer Centres, Crossroads branches and young carer projects. Carers Scotland, the Carers Trust, Shared Care Scotland and MECOPP are also members of the Coalition. The Coalition also has a small number of individual members (around 30). Payment of an affiliation fee is optional.

Crossroads Caring Scotland

Crossroads was established in the late 1970s to provide domiciliary care. Until 2012, it was part of a wider UK organisation. In 2012, Crossroads in England and Wales merged with the Princess Royal Trust for Carers to form the Carers Trust. In Scotland, however, Crossroads and the Carers Trust Scotland chose not to merge, and Crossroads now operates as an entirely independent Scottish charity. It is a company limited by guarantee.

In common with other NCOs, the Board consists of elected members (12) and co-opted members (up to 6). There is no eligibility requirement in relation to status as a carer.

Crossroads has three elements. It is:

• A direct provider of support to carers and their families through 24 directly managed services.
• An umbrella organisation for a further 17 affiliated services.
• A "representative" organisation (its " NCO" function).

The national office consists of 10 posts including the Chief Executive, and, in total, the organisation employs more than 800 people. This figure includes only directly managed Crossroads services. As noted earlier, Crossroads now directly manages 24 schemes. A further 17 schemes are affiliated. Each of the affiliates is an independent charity. Crossroads Caring Scotland (the national body) provides a range of shared services in return for an affiliation fee. The " NCO" element of the work of Crossroads (the representative function) consists of part of the time of the Chief Executive's post.

MECOPP

MECOPP was established as an independent charity in 2000. It is a company limited by guarantee, providing services directly to a number of ethnic minority communities within Edinburgh. Over time, as will be set out below, that remit has expanded significantly.

MECOPP has a Board of Directors, which, at the end of the 2012-13 financial year, consisted of nine members, seven of whom were carers. The Board is elected at an Annual General Meeting, and, in common with other NCO boards, can co-opt additional members.

In total, MECOPP has around 20 staff proving services in Edinburgh and in Gypsy Traveller projects. Although there are a number of BME-focused workers employed by organisations around Scotland, none of these is employed by, nor directly affiliated to MECOPP. The " NCO" element of MECOPP consists of part of the time of the Chief Executive's post.

MECOPP has 77 individual and 4 organisational members (although this does not relate to the NCO element of their activity).

Shared Care Scotland

Shared Care Scotland ( SCS) is a company limited by guarantee, and is a Scottish charity. The work of SCS is directed by a Board, elected at an AGM. The Board currently consists of seven members, together with three co-opted advisors. Although there is no eligibility requirement specified, carers can be co-opted onto the Board. SCS has six full-time staff, based in Dunfermline and is not a membership organisation.

The Alliance

As noted earlier, the Alliance is not a legally constituted body. It was created in 2001 as a means of bringing about informal networking, at which time it was agreed that there would be no benefit in formalising the structure.

The staff of the Alliance (3.5 full time equivalents) are employed by the Carers Trust, which also acts as the responsible body in relation to funding. The staff are line managed by the director of the Carers Trust.

The Alliance has a small management committee, drawn from its members. At present, the post of Chairperson is shared between two members. Unusually, the management committee has no responsibility either for the contract with the Scottish Government, nor for the day-to-day work of staff members. In both cases, this rests with Carers Trust Scotland.

The Alliance operates an open approach to membership, which is free. It has members not only from Carer Centre-based projects, but also from other voluntary organisations and, in a small number of cases, from social work-led services. The Alliance currently has a total of 48 members, of which 20 are associated with organisations affiliated with the Carers Trust.

Aims and areas of work

NCOs' aims and areas of work were explored in discussions with them. Additionally, some of the individual NCOs have formal strategic plans which provided further information.

In all cases, the aims of the individual NCOs appear to have been defined in the light of the work they do, and to be entirely consistent with, for example, the national strategy (see Section 1) and the purposes of the NCO Network (see Section 2).

The NCOs carry out a diverse range of work. Crossroads and MECOPP both have extensive local service delivery to individual carers, combined with a national management, policy and research function. The Carers Trust and Crossroads also provide a variety of support services to those organisations which choose to affiliate. The Coalition and Alliance both provide a range of services to their members. The main work of Shared Care Scotland is the distribution of Scottish Government funds for short breaks, as well as the overall development of policy and capacity.

Most of the NCOs undertake some form of policy work related to carer issues, as well as research to support this. A number undertake campaigning and advocacy work for carers (as well as carer organisations) at their own hand, as well as part of the NCO Network.

Carers Scotland

Carers Scotland works within the overall Strategic Plan for Carers UK, and does not have either a specific Strategic Plan or Business Plan for Scotland although, at the time of the review, the latter was being produced for 2014-15. The Carers UK plan, at the time of this review, covered the period from 2011-14, with a new version in preparation.

Carers UK describes its vision as:

"We want society to respect, value and support carers."

The Strategic Plan sets out five objectives for 2011-14 (and it is understood that they are unlikely to be changed in the new plan in summer 2014). These are:

• Providing carers with the support they need where and when they need it.
• Bring about lasting change through influence, education, and training.
• Giving carers a stronger voice.
• Partnerships in collaboration.
• Well-managed and governed organisation.

With the exception of a small project providing advocacy in one part of Glasgow (funded by the Scottish Government), Carers Scotland generally does not provide services directly to carers. This was a conscious choice by Carers Scotland. Carers UK provides some services in England.

The work of Carers Scotland has three main strands: advice; information; and campaigning. Carers UK operates a national helpline for carers five days per week, and this is accessible from Scotland. Carers from Scotland are directed to basic relevant information, and signposted to resources in Scotland. A monthly newsletter is circulated to all members, and includes both UK and Scottish policy and service issues. Carers Scotland is also able to circulate a wide range of briefings prepared by Carers UK on UK policy and financial matters (for example, the Budget and Autumn Statement, benefit changes and other legislation).

Carers UK has an extensive programme of research to which Carers Scotland generally contributes a Scottish dimension. A number of research reports and enquiries which have provided material for NCO Network publications.

Carers Scotland has chosen to focus on a number of areas of work which are quite separate to any of the other NCOs, taking forward work in relation to employers, telecare and telehealth. These areas of work have generated a number of UK level research reports which are also relevant to Scotland.

Carers Scotland also has a training programme, focused largely on service providers. This is separate from the training programme for carers funded by S10, and hosted by the Carers Trust (although Carers Scotland participates in this).

Carers Scotland (through Carers UK) has good links to national UK level issues. It also provides much of the administrative support for the NCO Network, and has organised the Carers Parliament (with funding and support from the Scottish Government).

Carers Trust

The objects of the Carers Trust are:

• The relief of those in need by reason of age, ill-health, disability, financial hardship or other disadvantage through the provision of comprehensive support services for carers throughout the United Kingdom, the Channel Islands and the Isle of Man.
• The assistance of carers in need including by raising awareness of issues affecting carers.
• The promotion of the efficiency and effectiveness of charities which operate for the care and support of carers.

The Trust has four key themes:

• Reaching out to more carers.
• Working with carers with complex needs (with a current focus on mental health and dementia.
• Improving the quality of services.
• Focusing on young carers and adult carers.

The work of Carers Trust Scotland splits into two main areas: work to support "Network Partners" (affiliated Carer Centres); and policy and development work on wider carer issues. The Trust also hosts the Alliance, as noted, and acts as lead partner for a National Training Consortium on behalf of the NCO Network.

In terms of support for Network Partners, the Trust provides a variety of services, including quality assurance and information. It also supports its Network Partners with employment, legal and other technical matters. Development work has been focused both on national issues and on supporting Carer Centres. As noted earlier, there is a current focus on mental health issues, and other areas of development work undertaken have included, for example: procurement; SDS; the use of social media; and the interface between community pharmacies and young carers. As noted earlier, the Trust is also working in the area of young adult carers.

A Fundraising Officer and a Partnership Development Officer are among staff employed at a national level, and both work at a national and local level on behalf of the Carers Trust and their Network Partners. The focus of the latter post is on developing links with non-carer organisations with an interest in carer issues, such as condition or age-specific organisations. A member of staff from the Trust undertakes a significant proportion of the policy-related work of the NCO Network.

Coalition of Carers in Scotland

The Coalition has a shared vision (consistent with the Shared Vision in "Caring Together") that:

"All Scotland's unpaid carers will feel valued, included and supported as equal partners in the provision of care, and will be able to enjoy a life outside of caring."

The Coalition agreed six aims in its current development plan:

• To strengthen the provision of information and mutual support to carers and carer-led organisations in Scotland, and strengthen communication between local carer-led organisations and national partners.
• To monitor and evaluate the impact, implementation and outcomes of national policy and legislation for carers locally.
• Develop and disseminate examples of best practice throughout Scotland and highlight areas where improvements are desirable.
• Develop a collective response to key issues enabling members of the Coalition to bring their concerns to the attention of interested parties at local, regional and national level.
• Promote the active participation of carers in local and national strategic planning meetings.
• Contribute effectively to the implementation of the Carers and Young Carers Strategy 2010 to 2015 'Caring Together'.

The work of the Coalition includes:

• Providing information and advice to member organisations and individuals.
• Providing an opportunity for networking and information exchange through quarterly network meetings.
• Carrying out local consultation, and supporting local engagement.
• Developing briefing and other material for circulation to members, as well as for the use of other organisations including the NCO Network.
• Promoting carer training.
• Campaigning directly as the Coalition, as well as supporting campaigning by members on local issues.

In 2012-13, the Coalition carried out a joint project with Volunteer Action Shetland to develop a virtual Carer Centre. It has been proactive in supporting a network of rural Carer Centres, though, for example, a regular teleconference. It has also acted as a channel for the views of Carer Centres in rural areas.

The Coalition has developed Best Practice Standards for Carer Engagement. It has also identified the Health and Social Care Alliance and Age Scotland as partners, with a focus on channelling information about specific conditions, and age-related carer issues to members.

Crossroads Caring Scotland

The overall aim of Crossroads is to:

"Improve the quality of life, health and well-being of carers across Scotland through the provision of short breaks and other practical support.

The organisation has four broad objectives:

• To develop sustainable local services throughout Scotland which provide practical support, including short breaks, for carers and their families.
• To ensure that such services are of the highest quality and exceed the expectations of carers, service users and regulatory bodies.
• To support the involvement of local carers and their families in the planning and development of local services.
• To inform the public debate on the need for greater access to and expansion of carer respite services.

Crossroads provides short breaks to carers and their families in their own homes. In 2013, Crossroads provided more than 820,000 hours of short breaks. Crossroads Caring Scotland is the national body which provides a variety of central services to directly managed schemes, and to affiliated Crossroads schemes.

MECOPP

MECOPP's vision is of:

"… a Scotland where minority ethnic carers have full and equal access to services and supports which promote and protect their quality of life and sustain them in their caring role."

In 2013, MECOPP secured external funding for an organisational review, facilitated by external mentors. This focused on the overall strategic direction of the organisation, and on the management of its diverse strands.

MECOPP's work is focused firstly, on improving outcomes for individual BME carers, and secondly, on a set of outcomes designed to ensure that organisations are better able to "recognise, understand and respond to the specific needs of BME carers." It was originally established as an organisation to provide support to BME communities in Edinburgh under contract to the local authority and NHS. However, in recent years, it has expanded its reach, and the largest strand of its work by value is in managing a variety of Gypsy Traveller projects in seven local authority areas around Scotland, with funding provided by the Scottish Government.

Although none of these activities can be regarded as central to MECOPP's status as an NCO, the organisation had provided specialist input and training in relation to working with BME carers to a number of organisations in Scotland prior to being invited to join the NCO Network in 2011-12.

In the last three years, MECOPP has been successful in securing non-recurring grant funding from a number of Scottish Government divisions to take forward work to extend elements of relevant Scottish government policy to BME communities.

MECOPP has developed an audit tool for use by public sector partners in relation to support for BME carers. The publication "On the Margins" was created with support from the Scottish government Carer Policy Branch and contains a diagnostic questionnaire and action plan. MECOPP also developed a training pack on cultural competences in single shared assessments.

MECOPP is presently undertaking a project, funded by the Carers Policy Branch, to enable BME employers to support carers. This is allied to the Kitemark project being taken forward by Carers Scotland (described elsewhere). MECOPP has also done work on the implementation of self-directed support ( SDS) in south Asian communities.

MECOPP has provided responses to a number of Scottish Government consultations, focusing on issues specific to BME communities, as well as being a signatory to NCO Network responses. Additionally, MECOPP and Carers Scotland were commissioned by the Scottish Government to develop a Carers Charter.

Shared Care Scotland

Shared Care Scotland's current purposes are:

• To improve short breaks policy and practice at all levels through collaborative effort.
• To advance good practice through research, learning exchange and development projects.
• To provide accessible, up-to-date information and advice about short breaks to those who use, provide or plan services.
• To connect people together to share experiences and ideas.

The bulk of SCS's work is related to the promotion of short breaks, the development of innovation in short breaks and the management and distribution of Scottish Government funds. In addition, SCS provides an online and telephone enquiry service to help carers and service users (as well as support providers) to find short break and respite services to match their needs. Information is also provided to national and local organisations about short break services.

SCS promotes events, networks, publications and learning resources to share knowledge, experience and successful practice. This work, although primarily in the area of short breaks, also extends to other areas of carer policy.

SCS has commissioned research on behalf of the NCO Network, both in its own right and using funding from the Scottish Government.

The Alliance

Although, as noted, the Alliance has no legal status, and is located within the Carers Trust, members agreed a specific statement of purpose, as follows:

"The Scottish Young Carers Alliance exists to service all young carers initiatives in Scotland with information and support to develop their practice and provide quality services to young carers. The Alliance also provides information and advice at strategic level, seeking to influence those developing national policy, guidance and legislation to ensure that the needs of young carers are acknowledged and met."

The primary direction for the work of the Alliance is taken from "Getting it Right for Young Carers", the National Strategy. The Alliance, as well as (it is understood) the vast majority of young carer projects, have adopted the outcomes set out within the National Strategy.

The work of the Alliance has two main parts: networking; and national services. There is substantial variation across Scotland in the work of individual young carer projects, and the perceived role of the Alliance is to facilitate the exchange of information between them. It hosts four meetings a year, which are promoted at no cost to attendees. The Alliance also acts as a channel for the views of young carers both to other carer organisations, and to the Scottish Government.

The Development Worker supports these activities, and also provides direct support to individual young carer projects and workers. Support has also been provided for the development of local young carer strategies. Although the post is based with the Carers Trust Scotland, support is available to any young carer organisation, regardless of affiliation. The Alliance also has access to policies, templates etc. from the Carers Trust, which can be made available to non-affiliated organisations.

The most visible element of national service provision by the Alliance is to promote and organise an annual Young Carers Festival. This is done nominally on behalf of the NCO Network as a whole. As a result of consultation with young carers at the Festival, the Carers Trust, on behalf of the Alliance, obtained funding to employ a Mental Health Development Worker. This post has now been extended to cover adult carers as well.

The Carers Trust at a UK level obtained a significant corporate donation to support work with young adult carers, a group previously identified in Scotland as falling between existing sources of support. This work is understood to be being taken forward as a Carers Trust Scotland project, although the local delivery of services may be taken forward alongside young carer projects linked to the Alliance. (A number of workers and carers who took part in this research expressed disappointment that this work was not being implemented as an NCO project, open to all Carer organisations). The Alliance has also taken part in an EU-sponsored project, "Together for Young Adult Carers".

Funding

Funding was examined in detail, although full details cannot be given here because of commercial confidentiality. Overall, however, the issue of funding is complex. As has been clear throughout this annex, the NCOs vary considerably in relation to their status, structures and work. This makes it difficult to distinguish the funding which relates (a) specifically to Scotland, and (b) to national level, or strategic work.

In the case both of Carers Scotland and the Carers Trust, neither publishes specific Scottish accounts. Both, however, were able to provide summaries of the budgets allocated to work in Scotland.

The Alliance has not published any accounts as it has no legal status. The host organisation, the Carers Trust, acts as the responsible body for the receipt of grant funding and all expenditure.

As in other respects, Crossroads and MECOPP are different to other NCOs in that a significant proportion of their income is derived from local contracts for service delivery direct to carers. Additionally, MECOPP delivers a number of services to Gypsy Travellers through Scottish Government grant funding. All of the NCOs, with the exception of the Alliance, benefit from some core funding from the Scottish Government in relation to their national (although not specifically Network) activities. The scale of this core funding varies considerably, as does the proportion of overall income it represents. Most of the NCOs also receive non-recurring grant funding. Much (although not all) of this funding is also derived from Scottish Government sources.

Both the Carers Trust (in relation to the Alliance and the NCO Training Consortium) and Shared Care Scotland (in relation to the management of government grant funding) also receive management fees.

The total amount of core funding provided by the Scottish Government to the NCOs was £613,080 in 2012-13.

The total funding overall in the last three years, excluding grants for short breaks distributed by Shared Care Scotland was:

• 2010-11 £543,545
• 2011-12 £1,196,699
• 2012-13 £1,267,808

Overview and perceptions of the individual NCOs

Throughout the research, a number of comments were made about individual NCOs. As the focus of this research was on the operation of the NCOs as a group, and not an evaluation of individual NCOs per se, some of the broad themes are discussed. These provide some insights into the perceived benefits of the individual NCOs, some of the concerns and challenges faced, and some of the issues which are relevant to the interface between the individual NCOs and the NCO Network.

Many comments were made on the overall effectiveness of the work of individual NCOs, with a wide range of examples of ways in which they were seen to provide a good service, to carers, workers and organisations.

Areas of work and the pattern of provision

Many comments were made on different aspects of the work of the NCOs. For example, the value of support from the NCOs to local organisations was highlighted, with some of the organisations responding to the survey suggesting that individual NCOs helped increase knowledge among support providers, as well as facilitating understanding of the "bigger picture". In some cases, NCOs were identified as an effective first point of contact for carers and organisations, and would make onward referrals.

Some NCOs were identified as either having services or interests tailored to the needs of particular communities of interest, or specific issues. Among the examples given were: rural communities; young carers; older people; BME carers; and LGBT carers. In terms of the coverage of the NCOs, it was suggested, however, that there could be gaps in provision to carers in some specific circumstances.

Respondents to the individual survey highlighted strengths of particular NCOs in terms of, for example: providing a channel for carers' views; providing a link to decision making and policy; awareness raising and campaigning; and research. These areas of work were also identified by both boards and staff members. A number of respondents to the surveys suggested (in various ways) that individual NCOs seemed "well-connected" to their members and affiliates.

In terms of the work of individual NCOs, however, an issue raised in some of the discussion groups was that their arms' length function in relation to carers means that they can only provide information on national issues, making it difficult to use this information locally, given the level of local variation in practice.

A number of participants in the review noted that there appears to be a positive approach to joint working among the NCOs (including to bilateral joint working, separate to the multi-lateral joint working facilitated through the NCO Network).

One of the concerns raised, however, by respondents of all types (including both national and local staff, board members and trustees) was a general lack of knowledge of the individual NCOs and a lack of clarity about what individual NCOs offer carers. It was argued, for example, that the "reach" of the NCOs was not as great as it could or should be, and one of the organisational respondents suggested that they were not proactive in communicating with small third sector organisations. It was also suggested that the titles of some of the NCOs did not always make their role clear, nor differentiate between them.

A further concern expressed was that some NCOs appeared to be no longer representative of their "constituencies", and had adopted much more of a "top-down" approach. It was also suggested by a few of the organisations responding to the survey that there appeared to be variations in the quality of the work of individual NCOs.

A further issue raised was that the challenging financial climate appeared to have led to NCOs taking on increasingly diverse areas of work, which, it was suggested, could result in a reduced focus on key areas of work. One of the discussion groups also expressed concern that the impact of some of the work taken on by individual NCOs would impact on the way they operate.

Composition of the NCOs

A number of carers suggested that having a number of NCOs, in conjunction with local carer organisations, meant that carers could have a choice of where to obtain support, including the option to obtain multiple perspectives on an issue should they choose to do so. This was also echoed by workers who identified that having multiple NCOs allowed them to choose, for example different routes to raising issues.

A common thread among the strengths identified for the work of the individual NCOs related to their knowledge, skills and expertise specific to the needs of carers. Individual NCOs were described by carers and workers, for example, as supportive, carer-focused, friendly and welcoming, and non-stigmatising. NCO staff and Board members also viewed these factors as among their strengths.

It was noted by some carers, as well as some staff and board members, that having a diversity of NCOs appeared to allow a greater level of focus on marginalised groups, such as people in rural areas, BME carers and older carers.

The most common concern, however, from participants of different types (but particularly carers and local workers), was that seven NCOs was "too many", and that there appeared to be areas of overlap in terms of their functions and services. A small number of organisational survey respondents also suggested that there was not always clarity about which of them were part of the NCO Network and what the criteria for inclusion were. Related to these comments, although there was little knowledge of the actual costs of the individual NCOs, some participants suggested that individual NCOs were "expensive", or did not provide good value for money.