QCS’s Alison Lowerson reveals the issues that every GP surgery should consider when it comes to carers and the steps that can be taken to support them.
Although it is sadly becoming a familiar situation, when the UK government announced a third national lockdown last month, it left some people feeling deflated, dejected and exhausted.
The last 10 months have been extremely challenging for most, but especially so for carers, who have provided continuous support for loved ones with limited support even before the pandemic started.
Who is considered a carer?
The title ‘carer’ is often misunderstood and the list of people who provide unpaid support to others is long. According to NHS England, it includes partners, relatives or friends who are simply ‘doing their best’ to help someone they care about.
But the definition is much more nuanced than that. Essentially, carers are anyone (they can be both children and adults), who looks after someone needing help due to illness, frailty, disability, a mental health problem or an addiction. Carers have a wide range of responsibilities too – including helping with personal care, mobility, managing medication, and liaising with social care teams.
Carers responsibilities have significantly increased
However, many carers have taken on more responsibility for their loved ones since the start of the pandemic and, with rapidly declining support due to the restrictions, they feel isolated, overwhelmed and are struggling to maintain the care that their loved ones’ need. With those who are clinically extremely vulnerable being advised to shield yet again, some carers will also make the difficult decision to shield with the person they care for. While this reduces the risk of passing on the virus, at the same time, it makes it hard for them to access food and medicines and financial support.
According to Carers UK, people who look after older, disabled and seriously ill relatives and friends are saving the UK state £530 million every day of the pandemic, valued at a staggering £135 billion so far.[i]
COVID vaccination for carers
The organisation says that under the terms of the new Covid vaccination advice published by the JCVI, carers, who receive Carer’s Allowance, should be included in Priority 6 alongside people with underlying health conditions. This will provide a huge relief to carers, and a lifeline for them to eventually get the help that they so desperately need.
Identifying and supporting carers
That said, GP surgeries and PCN’s have a key role to play. Practices can add value by better identifying those who are carers, thus ensuring that they have a better chance of getting the support they need. Simply asking ‘Do you look after someone?’ can be a more effective question than ‘Are you a carer?’.
NHS England and NHS Improvement has recognised the challenges that GPs face and it has produced a Framework of Quality Markers for supporting carers in general practice. The guide offers a series of practical ideas for improving how general practice can better identify and support carers of all ages. The quality markers ask:
- How the Practice identifies and registers carers
- How the Practice uses its carer’s register to support holistic carer health and wellbeing needs
- How the Practice organises itself to understand and respond to the needs of carers
- How the Practice makes it easier for carers to access its services
- How the Practice communicates with, involves and informs its carers
- How the Practice promotes a carer-friendly culture
When the CQC inspects, they look at how effectively carers are supported when they consider the following key lines of enquiry:
C2: involving people in decisions about their care
R1: how do people receive personalised care that is responsive to their needs?
So, the quality markers are questions that the CQC is likely to ask during an inspection or a telephone discussion. The framework document provides a whole range of practical ideas helping practices improve carer identification, support and health care.
Additional resources are available to support carers
The NHS Carers toolkit also helps organisations to work together in identifying, assessing and supporting the wellbeing of carers and their families. It also covers duties of NHS organisations brought about by the Care Act 2014 and the Children and Families Act 2014. It also includes numerous examples of positive practice that are already making a difference to Carers and their families.
Under the Network Contract DES Additional Roles Reimbursement Scheme there is expansion to include health and wellbeing coaches who will be expected to support patients and their carers, ensuring their changing needs are addressed.
Supporting carers in the workplace
“It is estimated that five million people juggle work and care in the UK – one in seven in every workplace – and this figure is set to increase. Given the stresses and strains that can result from balancing work and caring, it is unsurprising that 1 in 6 carers give up work or reduce their hours to care.” say Carers UK. Caring for someone, even when we are not in the midst of a pandemic, can be both physically and emotionally demanding and puts pressure on employees to balance their work and other responsibilities.
Practice Managers should monitor the emotional wellbeing of staff and, by asking employees if they are a carer and finding out the difficulties they may be facing, they will be able to support staff, including the opportunity of working or flexible working if possible. This not only demonstrates being a responsible employer, but it can also have a positive effect in the workplace and on the delivery of patient care.
In addition to the Home Working Policy and Procedure and the Flexible Working Policy and Procedure, QCS have produced an Employee Welfare Checklist, which covers staff issues and concerns as well as identifying any support they may need.
Practical steps to support carers
Working closely with carers, who are patients or staff, can promote a greater understanding of the challenges they face and providing much needed support can enhance working relationships. Practices should be raising awareness of caring and caring issues by supporting line managers and providing staff training, as well as reviewing policies such as the QCS Carers Policy and Procedure. Carers should be identified, especially in the workplace, and offered opportunities to manage their caring responsibilities, and they should be signposted to external support.
Additional resources
- Carers Policy and Procedure
- Home Working Policy and Procedure
- Flexible Working Policy and Procedure
- Employee Welfare Checklist