One in eight adults are a carer and carers save the economy £132bn per year.1
With an increasingly elderly population and push to keep patients at home for longer, GP practices have a vital role in identifying and supporting carers.
The RCGP has produced a very useful guide on how practices can improve carer identification and support. You can download this here. The college also has an elearning programme and other resources (see below for link).
Meanwhile, NHS England has recently produced a framework of quality markers for supporting carers in general practice. This provides a series of practical ideas for improving how practices identify and support carers. This is available here.
Key areas to consider are:
These are some of the ways practices can identify carers:
- Opportunistically by reception staff, GPs and practice nurses during patient encounters and consultations.
- In new patient checks and questionnaires. Think about adding the following questions to your registration forms: 'Do you care for somebody who could not manage without your help?' or 'Are you cared for by somebody?'
- Add carer questions to chronic disease templates.
- Ask at chronic disease reviews or at NHS health checks
- When forms are received by the practice regarding applications for Disability Living Allowance or Attendance Allowance, check whether the patient and their carer is on the carer register.
- Encourage patients to self-identify by having posters in the surgery, a carer notice board in the waiting room, and including information about carers on the practice website, in the practice leaflets and in practice newsletters.
- Information or messages about carers can be printed on repeat prescription slips.
- Add carers to the agendas of your multidisciplinary meetings. Community nurses will often have intelligence about patients and their carers as a large cohort of their patients are housebound.
- At flu clinics consider having carer awareness information available (posters and leaflets).
Train reception staff
Receptionists are the main point of contact with patients and their carers, they will also know many of your patients that are carers. Reception staff can provide informal support by asking them how they are and by supporting carers with suitable appointment flexibility and understanding
Think about appointing a carers lead to keep up momentum and keep the carers agenda on everyone’s radar. Ask your CCG or CEPN if there is any training or development support available for this role.
You could also add carers awareness training to your mandatory training cycle.
Inform receptionists about services that are available locally so that they can pass this information on. Local voluntary sector organisations who support carers may well be happy to come in and give a talk to staff.
- Have a carers pack which could include any of the following: (letter to carer informing them of practice carer incentives , letter to patient for consent to be given to the carer to have access to relevant medical information, carers’ leaflet, list of local carer organisations, other relevant health agencies and resources , past carers’ newsletters from the practice and/or local carer organisation).
- Have a carers notice board with information about local services and how patients can identify themselves as carers if they have not already done so.
- Consider a dedicated page on the practice website including information on the support available at the surgery and also links to local and national carer support organisations.
- Enhanced access and flexibility of appointments – think about if there are ways to be flexible with appointments if the patient is identified as a carer.
- Carer health checks: Carers are at increased risk of physical and mental health problems including back pain, stress, depression and strokes and as a group have increased mortality. Carer health checks can allow carers to think about their health before a crisis occurs. It can be helpful to add on some questions at this review about how they are coping in their caring role.
- Carers should also be offered flu jabs. If their carer gets ill, it is more likely the patient being cared for will end up in hospital.
- Signposting to local carer support services, social services and voluntary sector organisations. Active signposting is being rolled out across the country, so find out what support is available locally to train your staff in how to signpost and where to find out information on what services are available. Your local carers' organisation may also be happy to run carer awareness training in your practice.
Be a carer-friendly employer
Recognise that your staff may also be carers and that offering support where possible will help retain staff and make staff feel valued and respected.
Other larger scale ideas
The following are other ideas where practices can expand the support they provide to carers:
- Working with social services to provide information on personal health budgets
- Providing a benefits advice service for carers to help them access benefits they are entitled to.
- Working with the CCG to introduce a carers card which will allow health services to recognise carers if they pass through the system. This also enables healthcare staff to ask about the person cared for if carer has to go to hospital.
- Working with other health professionals to provide information and training sessions for patients (for example on manual handling, medicines management, benefits advice, health checks).
- Working with other local practices to develop a forum for carers to have a voice on local services and share information.
Fionnuala O'Donnell is a practice manager in Ealing, West London and a CCG board member
- The RCGP has a useful carers site, which contains resources for carer support
- NHS England. Supporting carers in general practice: a framework of quality markers
- Carers UK: National charity providing information and support, and campaigning for better recognition for carers. Adviceline: 0808 808 7777 email: firstname.lastname@example.org. Monday to Friday, 10am - 4pm
- The Carers Trust (formerly the Princess Royal Trust for Carers): National charity providing information and sources of support, including online chat forums
- Information about Carers Week
1. Carers Trust