- This guide has been produced to help local health services, local government, voluntary and independent agencies implement the National Strategy for Carers. It provides a detailed and practical look at the action needed by all agencies, from the NHS, local government and the voluntary and independent sectors, to meet national policy and new central directives to improve support to carers. It draws lessons from work across the country on 19 Carers Impact sites, and poses questions for partner agencies to assess and move forward their work to support carers. The questions are geared to commissioning, (including strategic planning, contracting and monitoring), as well as managing services and improving practice. The guide aims to focus on outcomes and asks questions about the impact of local policies, procedures and services. Examples of work undertaken by the different Carers Impact sites provide practical illustrations for implementing local joint strategies.