A carer is someone who, without payment, provides support to a relative or friend who could not manage without help. This could be due to age, physical or mental illness, addiction or disability. An estimated 12% of the population is undertaking a caring role at any time, although this dynamic group of people often don’t see themselves as carers. To them, caring is simply an extension of their role as husband, wife, child or sibling, although the balance in that relationship may have changed dramatically. In addition, there is evidence that carers endure health, social and financial disadvantage as a result of their caring responsibilities and up to 40% suffer from psychological distress or depression.
Despite their vulnerability, relatively few carers are acknowledged until a crisis occurs when they can no longer manage. Consequently a significant strain is put on GP practice resources. If carers often fail to recognise themselves as such, how can GPs identify them and if they do, what support can they offer?
Why GPs should support carers
Carers provide a valuable service to the people they look after and society in general but tend to neglect their own needs. Supporting carers requires multidisciplinary input and primary care is often the initial point of access for further support. Over 80% of carers have seen their GP in any year; a far higher proportion than any other professional support team will have seen.
Carers also know the people they care for better than anyone else, which can be extremely useful in planning patient care and identifying problems that may require intervention. Furthermore, carers are expert partners in care whose co-operation is needed to implement effectively any patient care plan. This is an essential part of good patient care and without the input of the carer vital information may be lost.
Ways to identify carers
- At registration, include a question in the new patient questionnaire. As many carers don’t consider themselves carers, phrase it as ‘looking after’ or ‘helping’ a friend or relative.
- Self-identification: put notices in the practice newsletter and waiting room as well as leaflets in languages other than English for ethnic minority groups. The annual flu vaccination campaign is a good time to encourage carers to come forward. Self-identification is the most likely method of identification if a carer is looking after someone not registered with your practice.
- Opportunistically: ask reception staff to check who requests repeat prescriptions, appointments and visits for sick, frail, elderly or disabled patients and substance abusers. Who brings such patients to surgery appointments and who else is there when visiting a patient’s home? This may be a way to identify young carers, who have additional problems given their age and position in the family.
- List searches: patients with certain conditions, such as dementia, Parkinson’s disease, MS, stroke, severe mental illness or disability may rely on carers.
Ways to support carers
Working as a team, practice staff can make the GP surgery an ideal gateway for carers to access support from appropriate sources. Ideally, one member of staff (anyone with an interest in carers) can become a ‘Carers Lead’ who will:
- Develop links with local carer agencies and illness-specific groups (stroke, MS, head injury, Parkinson’s) to act as a conduit between carers, the GP surgery and appropriate sources of support.
- Maintain and update the carer register ensuring that Read Codes are used appropriately.
- Obtain leaflets and posters about local carer support for the waiting room.
- Write updates for the practice newsletter.
- Audit the practice’s carer support by using the Action Guide for Supporting Carers, developed by the RCGP with the Princess Royal Trust for Carers.
- Keep colleagues up to date with developments in carer support both locally and nationally.
You can work through the RCGP e-learning module or request the DVD that has been created for in-house training. These are based on the Action Guide for Supporting Carers.
Carers form a significant and valuable part of a surgery’s patient list but are frequently overlooked. While some primary healthcare teams recognise the value of carers, others offer little support with single figures listed on practice carer registers. The aim is to reverse this situation by identifying those with caring responsibilities at an early stage, acknowledging their value and involving them as partners when planning individual care packages. GPs and their teams are the frontline professionals with whom carers have regular contact and often the only gateway to appropriate support services.
- Judith Cameron is RCGP Carer Lead for Supporting Carers in General Practice
- RCGP. Supporting Carers in General Practice email: firstname.lastname@example.org