Good practice in carer support
1. “Carer surgery” good practice - Brent
A Carers’ Centre worker ran a carers’ surgery at a GP practice for two hours a week for six months, which led to a large number of carer referrals.
At the end of the six-month period the budget could not be continued by the GP practice and, although the Carers Centre has stayed in contact with the GP practice, the lack of a visible presence has meant that the number of referrals has considerably reduced.
The Brent Carers’ Centre has also worked with other GP practices to influence the development of services for carers, working with link workers and putting in place training for primary care teams on carers.
2. “Rural carers” good practice - Suffolk
In Suffolk, due to the large rural area being covered by a single GP Development worker (a 20-hour-a-week post) it would not have been feasible to have a dedicated carer support worker in each of the 90 practices being targeted.
Instead the role of the GP Development Worker was developed to identify a “carers’ link” within each surgery or practice. The carers’ link is usually a practice manager, practice nurse or receptionist who may already have knowledge of caring either through personal or family experience. The aim is that each carer’s link will act as a central point for any carer trying to get support.
When this system works well, it works very well. Not only is the “carers’ link” present in the practice much more regularly than any external carer support worker could physically be, but they are automatically a part of the GP team. Back-up and expertise is provided by the GP development worker who undertakes one-to-one training with the carers link, and develops information packs for use within each practice containing localised information. If more intensive work or support is needed then the carer can be referred to the Suffolk Carers support worker.
In Ixworth Surgery, Sue Nutt, practice manager, is the carers’ link. In addition to providing carers with individual support – e.g. ensuring that Occupational Therapists are contacted for assessments, and benefits are claimed – she also runs a regular carers’ group, which puts on social events like the Christmas party. Her experience and involvement within the practice encourages all members of the practice staff to identify carers, and tag them on computer and paper records.
The development worker from Suffolk Carers has been running a carers’ surgery within the High Street practice, Lowestoft, and the practice manager is now participating in this. Similarly, at Beccles GP practice a carers’ drop-in service is facilitated by both the carers’ link within the practice and the GP worker from Suffolk Carers.
In each case, because the work is taking place within the surgery there is a very high feeling of “ownership” of the carers project.
However, as this work is not automatically a core responsibility there are drawbacks. The success, or otherwise, of the initiative does depend upon the commitment and involvement of the local “carers link”.
If the “carers’ link” does not have the full support of other members of the practice, or the status to insist on this, then the support can be tokenism. This could mean that, at worse, the time available for this activity can be reduced or squeezed out by other demands, meaning that it does not work well even as a referral service.
Although support for the “carers link” is provided by Suffolk Carers, it is not a direct line-management responsibility which can cause difficulties when trying to insist on remedial action if services are not being provided to a high enough standard or the expected numbers of carers are simply not being identified. The basic message is to encourage the work that is already happening, and hopefully foster improvements without being so critical as to be discouraging.
3. “Carer support worker” good practice – Harrogate
The Princess Royal Trust Harrogate Carers Resource has established close links with most local general practices.
Initiatives include carer notice boards, training staff, and facilitating reviews of practice policy and protocols for carers. In one GP practice, funding was secured to place a specialist carer support officer within the practice for 20 hours a week for 11 months. The carer support officer was recruited, trained, managed and supported by Carers Resource. The primary care team now identifies and refers carers, and this work is continuing in other GP practices in the area.
