This document establishes the procedures that the Practice has in place for identifying Carers to ensure they are appropriately referred for a Carers Assessment to Adult Care Services.
Definition of a Carer
Carers are people who, without payment, provide help and support to a family member, friend or neighbour who cannot manage on their own due to physical or mental illness, disability, substance misuse or frailty brought on by old age.
Caring roles can include administering medication, lifting and handling and personal or emotional care. Carers should not be confused with paid care workers, care assistants or with volunteer care workers.
A “Young Carer” is defined as a person under 18 who carries out significant caring tasks and by doing so, shoulders a level of responsibility for another person which is inappropriate for their age.
This situation often arises when parents who have long term conditions are not offered appropriate help and support, although it is a fact that most children of disabled or sick parents do not have to take on such responsible caring roles.
The person receiving care may not be registered at the Carer’s Practice. When this situation arises, because the Practice will not be always be able to ascertain that the Carer/Patient relationship has ceased, the Carer may be asked to re-confirm their Carer status.
Where the person receiving care is a registered patient at the Carer’s Practice, the Carer/Patient relationship can be verified more frequently, resulting in practice-held information being able to be modified when significant events such as death or de-registration occur.
It is important to estimate the total number of Carers within the Practice Catchment Area.
Monkseaton Medical Centre is likely to have 900 carers with over 300 of them caring for over 20 hours/week
The objective of this Protocol is to ensure that all Carers registered with the Practice are identified and referred to Adult Care Services.
The Practice will do its utmost to facilitate this process by actively identifying, supporting and referring known Carers who are patients of the Practice or where the person receiving care is a registered patient of the Practice.
The Practice will support Carers by:
- Identifying a “Carer’s Champion” to ensure that the support to Carers by the Practice is being undertaken and to be available to Carers as the first line of liaison
- Providing relevant information, Local Authority resources and contact points
- Providing suitable appointment flexibility and understanding
- Providing care, health checks and advice to enable them to maximise their own health and needs
- Routinely direct identified Carers (with consent) to local support services and, where appropriate, refer for Carers Assessment via Social Services
There are two proven methods of identification:
- Pro-active Practice Identification
The Practice undertakes the following activities as part of each method:
The Practice displays a poster on existing notice boards requesting Carers to contact the Practice to provide details of their caring responsibilities. However, during appropriate seasonal times (e.g. flu clinics) a notice board is dedicated to Carer information, for enhanced visibility.
Carer Referral Forms
Carer referral forms are displayed in reception to encourage Carers to complete and hand in to the Practice.
New Patient Registration Forms
The Practice’s new patient registration form incorporates the following two questions:
- Do you look after someone?
- Does someone look after you?
This information is used in the new patient screening appointment, tagging the patient’s notes and arranging referral to Care Services.
Pro-active Practice Identification
Letter and Questionnaire to Patients
When the Practice writes to a patient, (e.g. during the flu vaccination campaign), the communication incorporates a section on Carers, where if they are a carer but have not yet completed a Carer referral form, they are requested to contact the Practice and complete one. This may be part of the procedure for Disability Allowance forms.
Health Professional Identification
All Health Professionals in the surgery ask Carers to complete a Carer referral form when they ascertain a patient is a Carer. Many Carers may be identified as a result of Learning Disability Health Checks, Dementia Annual Reviews or Dementia Screening DES.
This is regularly discussed at multi-disciplinary team meetings to exploit personal knowledge. This will be of particular value at the High Risk Patient meeting.
Upon identification of a Carer the Practice will take the following steps:
- The Medical Record of the Carer should be edited to insert the ‘Carer’ Read Code of 918A and entered as an alert
- The Role of Carer should be marked as an ‘Active Problem’ so that it can be easily visible to the Clinician when accessing the Medical Record of the Carer
- An ‘Alert Message’ should be added to the Carer’s Record on the front desk to alert Receptionists in order for them to prioritise booking appointments where necessary
- The medical record of the person receiving care will be allocated a read code of 918F (“has a carer”) and cross reference the carers details in the text box
- Chronic Disease Templates used by Nurses and Doctors when consulting Patients include data entry spaces for inserting a Carer’s name and contact details
All Carer registrations will, in the first instance, be reviewed by the patient’s usual doctor who will confirm that the patient is competent to give a valid informed consent.
Process for Subsequent Referral
The following read codes are used to tag Carers notes where applicable:
- Carer 918A
- Has a Carer 918F
- No able Carer in household ZV604
- Carer unable to cope ZV608
- Referral for social services assessment 8HkB
The following documents are available on the practice Intranet and on the practice Website support this policy:
- Carer’s Support Policy
- Carer’s Identification and Referral Form
- Agreement by a Patient to allow a Carer to have access to their Personal Details and/or Copies of Correspondence
- Contact Points
Call Carers Direct on 0300 123 1053
The RCGP also has some useful resources.
Young carers are children and young people aged 5-18 who help to look after somebody in their family because they have a disability, illness, mental health difficulty or misuse drugs or alcohol. There are many young carers in North Tyneside and GPs and primary care staff are well placed to identify them. If you identify a young carer, you are encouraged to signpost them to North Tyneside Carers’ Centre where they can access support and advice. The contact details are:
0191 643 2298
North Tyneside Carers’ Centre, 3rd Floor, YMCA Building, Church Way, North Shields, NE29 0AB