Identification and Referral
Identification and referral of carers involves establishing systems within practices to enable the practices to identify carers and refer to the local Carers' Centre and other appropriate agencies.
Without a structured, systematic way of identifying carers and patients who have a carer, it is almost impossible to implement a policy of providing support to carers. Setting up such a system and keeping it up to date need not require substantial extra staff time and will add real value to the services that the practice provides.
Developing a carers’ register allows practices to monitor how many carers they have identified and are providing support to. Under the new GP contract, the large majority of practices have claimed the relatively small amount available for establishing a register and referring carers for assessment. However, there is strong evidence to suggest that that the number of carers identified is still only a small proportion of the number of carers out there. Identifying some carers may be enough to meet the requirements of the new contract but it is not enough to make a real change to those carers’ lives. If we take a typical five-doctor practice looking after about 8000 patients, about 800 of these will be carers, of which about 270 will be caring for more than 20 hours a week, including about 160 who are caring for more than 50 hours a week – considerably more than a full-time job. These figures should be used as a benchmark by practices to self-assess how well they are doing in identifying carers.
Structured recognition helps the carer to feel that their contribution is acknowledged and valued, and that they are part of a team providing health care to the person being cared for. This in itself is likely to have a positive effect on the way carers approach the practice and use its resources. It will enable the practice to monitor the caring situation more effectively, and identify problems at an earlier stage, and to provide both appropriate information and other support to the carer and the cared for person. It will also enable the practice to communicate this information to other agencies and professionals, such as hospitals, who might be able to prioritise and adapt assistance or services given to carers.
Identifying carers and referring them on should be viewed as one process. There is limited value in identifying carers within primary care unless there is a plan to do something positive with that information.
Research with carers highlights the fact that carers have expectations of the NHS in general and primary care in particular as being providers of information. There has however, been a lack of information from primary care staff for carers and this can have a particularly negative impact – carers and patients may assume that because their GP hasn’t told them about them, services don’t exist.
