One in every eight adults in the UK cares for ill, disabled or frail family members, or friends on a voluntary basis.
These 'hidden carers', some of them children, can suffer mental and physical ill health, often relating to their voluntary role, yet many are reluctant to seek support.
A pilot scheme in south-west Surrey is working to help GPs identify these carers and point them in the direction of help. As well as providing vital support, it is hoped the scheme will help cut NHS costs.
'If a carer's own health breaks down it places a huge responsibility on the NHS to pick up the pieces,' says Alison Brock, the carer recognition worker who runs the project.
GPs and primary care professionals who come into contact with carers can encourage them to recognise their role - sometimes simply by saying 'you are a carer' - and referring them to sources of advice.
Carers health problems typically include depression, physical strain from moving the person they look after and stress.
Ms Brock visits practices to talk about how to spot the hidden carers, coax them into acknowledging their role and encourage them to take advantage of resources available.
Some solutions include nominating a member of staff to be a link between the practice and local support groups, or adding a special carer area on their website, or offering direct, practical help - such as annual flu jabs - to those who have been identified.
Dr Alastair Bint, a GP in Guildford, says the project has helped to keep the issue part of the focus at his practice.
'On a recent home visit I asked the wife of a patient if she would like help as she was clearly a carer - she was very thankful,' he says.
'If I am seeing a patient with a chronic illness my mind is now more focused on if there is a carer looking after them.'
He has also improved the practice's search for carers. 'We have a carer pack in the waiting room, but it hardly ever gets looked at,' says Dr Bint.
'We think that is because there is a stigma about being a carer. In a waiting room we are surrounded by people.'
Now the practice advertises to carers on the bottom of all repeat prescriptions, in their practice newsletter and on their website, asking them to talk to their GP.
Help carers to help others
Dr Helen Roberts, a GP in Farnham, was recently approached by a carer seeking help for depression who had seen a notice on her practice's website.
'Many carers feel that if they ask for help people will take it as they don't want to care for that person. Because this lady had identified that the practice wanted to hear from her, she came forward and is now on antidepressants and feeling much better,' says Dr Roberts.
The practice is set to launch an online forum on the website for carers of different ages to talk to other local carers.
The Carers Recognition Project funded by Surrey PCT, local contacts and the South West Carers Strategy Group, will run until next March, and both Dr Roberts and Dr Bint believe the scheme should be rolled out nationwide.
'Primary care is usually reactive healthcare, but with carers we need to be more proactive, we need to seek them out and offer them help,' says Dr Bint.
Finding the 'hidden carers'
- Include the question 'Are you a carer?' on new patient registration forms, including children's forms.
- Promote help for carers on prescription forms and other patient letters such as flu jab invitations.
- Promote help in the practice booklet, posters and plasma screens.
- Advertise at disease management clinics - such as well woman, well man, asthma and obesity clinics. Clinic questionnaires could ask 'Are you a carer?'
- Encourage an overall feeling that you are a 'carer-friendly' practice as this will help patients admit their caring role.
How to help the carers you identify
- Flag prominently on the patient's notes that they are a carer, so that all health staff, including receptionists, are aware.
- Make readily available supporting literature and information for local carer support groups.
- Offer regular health checks to carers.
- Be flexible with carers' appointments.
- Explain that carer assessments are available and refer a carer to social services if permission is given.