Introduction and Overview
The National Carers Strategy identified the National Health Service as being the first and most important point of contact for the majority of carers (The National Carers Strategy, 1999). It is therefore vital that GPs play a pivotal role in identifying increased numbers of the ‘hidden carers’ who continue to fall through the system.
There are currently an estimated 60,000 carers in Manchester (Manchester Carers Strategy 2008 – 2011), of which the majority are unknown to Social Services or their local GP with an estimated 1 in 10 patients in a practice undertaking caring responsibilities, which may have an adverse affect on their health and well-being (Best Practice, Better Practices – A New Deal for Carers In Primary Care 2006).
The practice should have a procedure for how carers are identified and a referral protocol to social services for assessment of carers support needs or to other local support such as carers centres.
A carer is identified as, someone who, without payment, provides help and support to a relative, friend or neighbour, who could not manage to stay at home without their help due to age, sickness, addiction or disability.
The practice should remember to include any young carers who are particularly vulnerable.
- NHS Carers Information Strategies guidance – HDL22 (2006) (sections 3.3 and 3.10)
Methodology For Identifying Carers
Identifying a Carer will enable them to receive information, advice, support and training which may include financial assistance.
Carers are identified by:
- All new patients are asked about caring responsibilities on New Patient Questionnaire – this information is then entered into the patient’s clinical record by Debbie Mohammed
- There is a notice in the waiting room inviting patients to identify themselves as carers
- Patients are asked opportunistically during consultations about caring responsibilities
- Occasionally, members of the reception team may learn of a patient’s Carer status and are aware that the Practice Manage or a doctorr should be informed
Mechanism For Referral
Patients who identify themselves as carers can be referred to Manchester City Council by faxing the attached referral form. (refer to Items 2, 3 and 6 of MCC Toolkit).
To refer a patient for Carers Assessment, please contact Manchester City Council’s Contact Centre on 0161 255 8250. Please note that this is for residents of the Manchester City Council area only – external residents will need to be referred to their local authority. It may therefore be necessary to contact local services outside the Manchester area, especially for practices residing near boundaries, as a change in practice process may have an effect on their workload i.e. increased number of referrals/queries.
As the role of a Carer is most likely to change with time, it has been recommended by Social Services for a Carer to be re-assessed at least once every 12 months.
Practice Carer Lead
The Practice Manager/Nominated Other Member will be the Carer Lead and will:
- undertake the role of maintaining and monitoring the Carer Protocol within the practice
- promote an awareness of caring services and available literature amongst the practice team
Acknowledging A Carers Status
Once a Carer has been identified, it is then necessary to document this information accordingly and create a dedicated dynamic Carers Register. This would enable GPs to identify who a Carer is and take into account their unique and individual needs. This information may then be passed over (consent must be provided by patient/carer) to other agencies and professionals i.e. hospitals etc.
- Once a Carer has been identified their Carer status will be entered into their clinical record using the appropriate Read Codes illustrated on page 7 of this document.
- A Carer Register will be created by the Practice Manager conducting a search of these codes on the practice’s clinical system on a 3-monthly basis
- New Carer’s will be asked if they wish to complete a Carer’s Self-Referral Form for submission to the Carer’s Strategy Team at Manchester City Council
Supporting A Carer
- Carer’s can either be offered or request longer appointments with the doctor or nurse
- The practice will endeavour to provide any relevant literature, website addresses, contact numbers for Carer’s upon request
- Practice staff are aware that Carer’s have special needs and will respond to these, where possible and appropriate
Under Age Carers
Carer’s under the age of 18 are identified when they come in with the patient or when a clinician has been to the residence for a visit.
i.e. annual reviews, carer surveys, feedback to staff and carers etc.
Appropriate/suggestive Read Codes
- 918A Carer
- 918G Is a carer
- 918F Has a carer
- 918H Primary Carer
- 918V Does not have a carer
- 918f Is no longer a carer
- 918c Carer of a person with chronic disease
- 918m Carer of a person with a terminal illness
- 918W Carer of a person with learning disability
- 918X Carer of a person with physical disability
- 918d Carer of a person with mental health problems
- 918y Carer of a person with sensory impairment
- 918a Carer of a person with substance misuse
- 918b Carer of a person with alcohol misuse
- 918g Parent is informal carer
- 918h Child is informal carer
- 918i Relative is informal carer
- 918j Partner is informal carer
- 918k Friend is informal carer
- 918l No longer has a carer
- 3892 Assessment of needs of carer completed
- 671E Discussed with Carer
- 807 Carer Support
- 9180 Carer Details
- 918E Is A Carer