Primary care

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Guidance

Partners in Care

The Royal College of Psychiatrists and The Princess Royal Trust for Carers (now Carers Trust) joined forces and launched the Partners in Care campaign. The partnership produced a range of leaflets on specific conditions and a comprehensive toolkit.
Area of Care: 
Mental Health
Outcomes: 
IntegrationCarer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsMental health careHealth and wellbeingCarers involvementCommissioning
Location: 
Whole UK
Date Revised: 
Thursday, May 10, 2018 - 14:30
Body: 

The Royal College of Psychiatrists and The Princess Royal Trust for Carers (now Carers Trust)  joined forces and launched the Partners in Care campaign in January 2004.

The objectives of the campaign were to highlight the problems faced by carers of all ages of people with different mental health problems and learning disabilities, and encourage true partnerships between carers, patients and professionals.

The partnership produced the following leaflets:

  • checklist for professionals working with mental health carers
  • checklist for professionals working with children of parents with mental health problems
  • checklist for carers meeting with psychiatrists
  • confidentiality leaflet.

The partnership also produced a range of leaflets on specific conditions and a comprehensive toolkit.

To find out more and access the leaflets, visit the Partners in Care website.

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A Road Less Rocky - Supporting Carers of People with Dementia 

In May 2012, Carers Trust commissioned the Social Policy Research Unit at the University of York, and Firefly Research & Evaluation, to undertake research to ‘understand more about the caring journey undertaken by carers of people with dementia and the challenges they face, from initial concerns that there may be something wrong to experiences at the end of life and afterwards’.

England and Wales

The Mental Health Act 2007 amends the previous 1983 Act, which governs the compulsory treatment of certain people who have a mental disorder.

In 2015 the government published a new Code of Practice for the Mental Health Act (1983), Carers Trust published a briefing on the key points and what this means for carers.

Carers Trust Mental Health Act Code of Practice 2015 Briefing

Mental Capacity Act 2005

The Mental Capacity Act sets out how people who lack capacity now or may do in the future should be treated and their rights protected.

Scotland

Mental Health (Care and Treatment) Scotland Act 2003

This Act outlines how individuals with a mental disorder are to be treated in community and inpatient settings. 

Adults with Incapacity (Scotland) Act 2000

The Adults with Incapacity (Scotland) Act provides safeguards and standards for the rights of adults who are assessed to lack capacity to make decisions.

Northern Ireland

The Mental Health (Amendment) (Northern Ireland) Order 2004

This Order outlines how individuals with a mental disorder are to be treated in community and inpatient settings.

Current Mental Health Research

Research specifically on mental health caring is more sparse, but examples can be found on the sites below.

 

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Guidance

Working with carers of people with mental health issues

Carers of people with mental health issues deserve support, both in relation to the people they care for, and for themselves as carers. Indeed, carers are often working long hours, in unpredictable circumstances and with little or no help, to care for those closest to them.
Area of Care: 
Mental Health
Outcomes: 
PreventionWellbeingIntegrationCarer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsMental health careHealth and wellbeingCarers servicesSocial careCommissioning
I work with: 
Adult carersParent carersFamilies
Caring for: 
AdultsOlder adultsYoung peopleChildren
Location: 
England
Date Revised: 
Thursday, May 10, 2018 - 13:45
Body: 

Carers of people with mental health problems come into contact with a range of health and social care professionals. Both in the community and in healthcare institutions, carers routinely link with psychiatrists, social workers, nurses, GPs, voluntary and charity staff, as well as many other workers.

Invaluable aid to health professionals

Carers of people with mental health issues deserve support, both in relation to the people they care for, and for themselves as carers. Indeed, carers are often working long hours, in unpredictable circumstances and with little or no help, to care for those closest to them. But in this way, carers are often an invaluable aid to health professionals' work, giving an experienced insight into the care and needs of the service user.

However, there are always challenges working with, and involving carers of people with mental health issues. Dealing with issues such as confidentiality, disputes over care and treatment, and balancing the different needs of carers and service users are common experiences for many healthcare professionals. In this sense, professionals also need support, and the necessary resources to work in partnership with carers. 

Overview of issues

An overview of the issues faced by carers has been produced by Carers Trust, as well as an outline of the key changes which we would like to see happen nationally. 

Making Respite Real in Mental Health

Carers of people with mental health problems benefit from a break from their caring role just like other carers, however, research undertaken by Carers Trust showed that many carers, service users and professionals were unaware of how to respite and carer breaks. Carers Trust has developed guidance for professionals, carers and service users to promote the value of respite, the need for it to be planned for and how to access it.

Download the leaflet  Making Respite Real in Mental Health.

The guidance is suitable for carers, professionals and service users.

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Research

Full of Care Report - Young Carers in Wales 2009

In 2009 the Children's Commissioner at the time, Keith Towler, launched new research and recommendations for Young Carers Services in Wales.
Outcomes: 
PreventionWellbeingIntegrationHealth inequalitiesCarer awarenessIdentifying carers
I work in: 
Primary careHealth and wellbeingCommissioning for young carersSocial careEducationCommissioning
I work with: 
Young carers
Location: 
Wales
Date Revised: 
Friday, May 4, 2018 - 10:15
Body: 

The report, entitled Full of Care, aimed to show the barriers young carers face achieving the rights laid out by the United Nations Convention of the Rights of the Child, such as the right to education, to relax and play and to have their views respected. 

The document included the research project All Right Gov' that Powys Carers Service carried out in Summer 2008, travelling all over Wales to meet other young carers projects and listening to their experiences.

The report made a number of recommendations to both Welsh Government and local service boards as well as local authorities, health and The Department of Children, Education Lifelong Learning and Skills.

Early identification and intervention

The fact that 54% of young carers in this survey felt that they only got support in a crisis underlines the importance of early identification and intervention. However, the young carers who took part in this survey were those who had been identified and were receiving support. 

Much of the existing guidance is intended to prevent crises arising through early identification and intervention. It is clear though that there is often a considerable gap between national policy and local practice.

The message ‘Too little, too late’ still resonates today.

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Guidance

Flu Vaccinations for Carers campaign - useful resources

NHS Employers and Carers Trust produced flu campaign guidance and resources in 2014 which healthcare staff can download .
Area of Care: 
Primary Care
Outcomes: 
PreventionWellbeingCarer awarenessIdentifying carers
I work in: 
Primary careHealth and wellbeingPharmacy ServicesCarers servicesInformation and adviceCommissioning for carersSocial careCommissioning
Location: 
England
Date Revised: 
Friday, May 4, 2018 - 09:15
Body: 

Help reach carers across the whole community

NHS Employers and Carers Trust  produced flu campaign guidance and resources in 2014. Carers Trust also produced a set of resources aimed to be used by a wide range of organisations to as well as individuals to encourage flu vaccination uptake among carers. The resources also encourage carers to get in touch with Carers Trust for details of their local carer service. 

The Word versions of each resource were designed to be customised to include your organisation’s own logo.

Further details

For more information about the Flu Vaccination Campaign for Carers, please email Carers Trust.

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Good Practice

Supporting Carers in Primary Care Learning Event

Carers Trust hosted the Supporting Carers in Primary Care Learning Event in November 2014. The event brought together over 100 professionals from across the sector who work to identify and support carers across primary care.
Area of Care: 
Primary Care
Outcomes: 
PreventionWellbeingIntegrationHealth inequalitiesCarer awarenessIdentifying carers
I work in: 
Health carePrimary careMental health careHealth and wellbeingCarers servicesInformation and adviceCommissioning for carers
I work with: 
Adult carersParent carers
Caring for: 
AdultsOlder adultsYoung peopleChildren
Location: 
England
Date Revised: 
Friday, May 4, 2018 - 09:00
Body: 

Carers Trust hosted the Supporting Carers in Primary Care Learning Event in November 2014. This annual event was funded by the Department of Health as part of the wider Supporting Carers in Primary Care programme. 

The large scale event brought together over 100 professionals from across the sector who work to identify and support carers across primary care. 

The day provided an excellent opportunity for sharing information and good practice and the additional networking hour at the end of the day provided the ideal opportunity for delegates to reflect on what they had learnt together. The  evaluation feedback demonstrates that delegates found the day both informative and useful.

The programme

Rick Bolton, who cares for his four-year-old son led the day, sharing his account of what being a carer means to him. Delegates heard from a variety of expert speakers including Wendy Nicholson, Professional Office for School and Community Nursing at the Department of Health, Jen Kenwood, Head of Patient Experience – Community, Primary and Integrated Care at NHS England and Moira Fraser, former Interim CEO and Director of Policy at Carers Trust, as well as taking part in a selection of workshops. 

View the presentations

The event presentations will be useful for staff from carers services and other organisations who support carers in primary care.  You can also preview what was covered in the workshops. 

Supporting Carers in Primary Care Learning Event – view the presentations

 

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Good Practice

Supporting Carers in Primary Care Learning Event – presentations

View the presentations from the Supporting Carers in Primary Care Learning Event that Carers Trust hosted in November 2014.
Area of Care: 
Primary Care
Outcomes: 
PreventionWellbeingIntegrationHealth inequalitiesCarer awarenessIdentifying carers
I work in: 
Health carePrimary careMental health careHealth and wellbeingCarers servicesInformation and adviceCommissioning for carers
I work with: 
Adult carersParent carers
Caring for: 
AdultsOlder adultsYoung peopleChildren
Location: 
England
Date Revised: 
Friday, May 4, 2018 - 09:00
Body: 

These presentations will be useful for  staff from carers services and other organisations who support carers in primary care.  You can also preview what was covered in the workshops. 

Morning plenary presentations 

Policymaking to primary care practice making it happen at the sharp end (Moira Fraser, former Interim CEO and Head of Policy, Carers Trust)

Moira Fraser explained that much needs to be done to turn the rhetoric into reality and overcome the barriers facing carers organisations working with the NHS to identify carers. 

Cosying up: how CCGs can partner carers (Dr Michael Taylor, Lead GP for Carers Services at Heywood, Middleton and Rochdale CCG)

Find out which strategies Dr Michael Taylor recommends to improve support for carers by working in partnership with CCGs.

RCGPs supporting carers in general practice programme (Dr Nazia Mohammed, Clinical Champion for Carers, RCGP)

Dr Nazia Mohammed provided an overview of the College’s work to improve carer identification and support in general practice.

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Morning workshops 

Delegates were able to choose between the following morning workshops:  

How to network effectively across the health economy to maximise support for carers (Michelle Pilling Lay, Advisor Quality & Patient Experience, East Lancashire CCG)

An overview of the current landscape in health and the opportunities to maximise the impact of the Primary Care Identification Worker.

GP audits and GP investors in carers standard accreditation (Louise Shaw, Primary Care Lead & Carer Assessment Support worker and Hazel Wright, Adult Services Manager, Northampton Carers)  

Outlines the successes and challenges of co-produced primary care Interface work over five years with specific focus on the implementation of annual audits and the launch of Northamptonshire Investors in Carers Standard accreditation.   

Developing and maintaining a carers links network in Salford (Julia Ellis, former Development Manager for Primary Care and Outreach, Carers Trust)

Provides an overview of the successful and well-established Carers Links Network in Salford. Learn how the service that provides 300 referrals per annum from the primary care sector was established, developed and maintained.

Effective monitoring and evaluation tools to assess the impact of emotional support services for carers (Clare Edwards, Carer Health Worker, West Cumbria Carers)

Explores how to effectively assess the impact of services in supporting carers’ mental wellbeing using questionnaires developed by NICE.  

We also held a workshop on young carers which was  led by Rick Bolton, Dr Nazia Mohammed and Daniel Phelps. It was agreed we all need to work together to generate a culture of change and focus on developing good long term relationships to encourage lengthy engagement. Solutions discussed included:

  • A whole family approach - ensuring young carers are identified when parents present with chronic illness for example.
  • GP awareness training - the same read code would be used for young carers as adult carers.
  • Remembering that primary care is much wider than GP surgeries.
  • NHS employees’ awareness training.
  • Continued identification through schools / colleges.
  • Identifying young carers early through health visitors and children’s centres.
  • Importance of relationships such as a long-term relationship between pharmacy staff and families.
  • Professionals having the awareness of young carers and the confidence to ask appropriate questions.
  • Important to find champions with passion to drive work forward in own establishments.

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Afternoon plenary presentations

Community pharmacy - how can it help support carers (Alastair Buxton, Head of NHS Services at PSNC) 

Describes the community pharmacy services which can support carers and the Carers Trust / Pharmaceutical Services Negotiating Committee pilot to test carer identification in community pharmacies in England.

Supporting the health and wellbeing of carers (Wendy Nicholson, Professional Officer for School and Community Nursing at the Department of Health)

Demonstrates that community nurses are keen to extend their understanding of carers’ needs and to ensure carers’ wellbeing needs are met.

Further guidance on supporting adult carers through community nursing can be found on the Supporting adult carers through community nursing page.

NHS England commitment to carers - can it make a difference (Jen Kenwood, Head of Patient Experience – Community, Primary and Integrated Care, NHS England)

Described NHS England’s commitment to carers, which comprises 37 commitments spread across eight key priorities, from raising the profile of carers to person-centred coordinated care. 

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Afternoon workshops

Delegates were able to choose between the following afternoon workshops:

The carers health team: a methodology to prevent carers falling between the gaps in our systems (Geoff Coleman, Chief Executive, Crossroads Care South Central)

Explored using a collaborative approach to support carers involving a partnership between Crossroads Care, Carers Health Team (NHS) and Carers Support West Sussex.

Carer awareness training for pharmacies (Anne Cole, Regional Manager South West, CPPE)

A guide to the new carer-awareness training resources for pharmacy teams co-produced by the Centre For Pharmacy Postgraduate Education (CPPE) and Carers Trust to improve the identification and referral of carers and how this fits into the Carer Friendly Pharmacy Pilot.

Supporting carers through integrated care (Helen Brown, Health Development Lead Carers Resource, Harrogate) 

Evidences the value of providing support for carers by establishing a service for carers within Integrated Care Teams. It highlights the success of the service in identifying and reaching out to ‘hidden’ carers and the benefits to all the multi-disciplinary professionals involved.

Supporting carers through e-learning for community nurses (Jennie Whitford – Carers Project Manager, QNI) 

Explores the digital Carers Resource for community nurses which has been developed by The Queen's Nursing Institute in collaboration with nurses working in the community.

 

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Toolkit

Time to Think About You

Time to Think About You is a new resource which has been co-produced with The Health Innovation Network (HIN) in South London to help carers self-identify and access support.
Area of Care: 
Primary Care
Outcomes: 
Carer awarenessIdentifying carers
I work in: 
Health carePrimary careCarers services
I work with: 
Adult carersYoung adult carersYoung carersParent carersSibling carersFamilies
Caring for: 
AdultsOlder adultsYoung peopleChildren
Location: 
Whole UK
Date Revised: 
Monday, April 30, 2018 - 14:15
Body: 

The Health Innovation Network and Carers Trust have worked with carers on Time to Think About You.

Time to Think About You is a project to encourage carers to be more aware of their own health, and the support available to them at their local GP and carers services.

We have developed a range of materials for this project, including a poster and prompt cards.

You can help us to raise awareness among carers by sharing these, putting them up in your workspaces, and giving them out to any carers you may know. 

Download the Time to think about you materials

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Good Practice

Supporting carers of people with dementia in black, Asian and minority ethnic communities

A good practice example of working with carers of people with dementia from diverse communities by the Dementia Information and Support for Carers (DISC) service hosted by Sandwell Crossroads Birmingham
Area of Care: 
Mental HealthPhysical illnessSpecial education needsSpecialist servicesDay centreRehab CentreHospitalCare homesDementia care
Outcomes: 
Carer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsMental health careHealth and wellbeingPharmacy ServicesCarers servicesCarers involvementCarers breaksInformation and adviceCommissioning for carersCommissioning
I work with: 
Adult carersFamilies
Caring for: 
AdultsOlder adults
Location: 
Whole UK
Date Revised: 
Monday, April 30, 2018 - 13:45
Body: 

DISC Dementia information and support for carers

The Disc Service was launched 11 years ago, it is hosted by Sandwell Crossroads and funded by Sandwell and West Birmingham, Cross City, South Central CCG’s, and Birmingham City Council through the Birmingham Bettercare Fund

The service originally operated in West Birmingham, but had funding extended to cover the entire Birmingham City Council area.

The service is focused on supporting carers from the diverse communities in the Birmingham area. The DISC service prides itself on being proactive in recruiting staff from local black, Asian and minority ethnic (BAME) communities who have both the language skills and understand the cultural sensitivities.

The service supports over 400 carers and offers Iiformation, advocacy and support for carers, though one-to-one contact and successful weekly information and support groups.

It also offers a signposting and referral service into other local statutory and voluntary sector services.

Examples of the type of help and support carers have receive:

  • Accessing respite
  • Liaising with district nurses, occupational therapists and social workers.
  • Continence advice and support.
  • Advice in managing changing and unusual behaviours.
  • Finding the right care such as day centres, care homes and care agencies.
  • Talking to the wider family.
  • Advice on benefits and carers' rights.
  • Information on the Mental Capacity Act.
  • Information on lasting power of attorney

DISC's strengths

  • Building relationships with carers over a long period of time.
  • Stepping in to offer support before a crisis develops.
  • Bridging the gap between clinical diagnosis and families coping alone.
  • Making carers feel welcome – 14 of them formally volunteer in supporting other carers.
  • Being led by carers, listening to carers and developing services to meet need.
  • Feeling passionate about the service.

Further information

For more information on the service contact Jo.Moon@sandwellcrossroads.org or visit the Sandwell Crossroads website.

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Toolkit

GP Practice Quick-start Toolkit

A variety of tools and practical guidance to enable GP practice teams to identify and support patients who are carers.
Area of Care: 
Primary Care
I work in: 
Health carePrimary care
Location: 
England
Date Revised: 
Monday, April 30, 2018 - 13:15
Body: 

GP practice carer questionnaire

Find out how successful your practice is in supporting patients who are carers and how you might be able to support them better in future using this Carer Questionnaire which you can display in your practice waiting room and ask staff to hand out to patients they already know to be carers. 

Download a Word version and adapt it to suit your needs.

Identify carers through the condition of the person they care for

Carers can sometimes be identified through the person they care for by searching through disease registers and focusing on patients with medical conditions where it's likely that they'll be supported by a carer. Download our list of conditions suggesting a patient may have a carer for some suggestions.

You can then send our letter to patients with a condition suggesting they have a carer to the carer via the patient with the medical condition. There's a cover note attached to the front of the letter asking the patient to pass it on to the person who looks after them. As well as encouraging the carer to identify themselves to you, it also recommends a referral to their local carer service for information, advice and support.

For patients whose carer is registered at a different GP practice, the letter suggests they let their own GP practice know instead. Download the letter to patients with a condition suggesting they have a carer as an editable Word document.

Refresh your carers register

Every day, 6,000 people in the UK become carers and for a similar number of people, caring comes to an end, which is why your carers register can easily become out of date. Download our letter to patients already identified as a carer which asks the carer on your register to let you know if they're no longer looking after someone. For those who are still carers, the letter encourages them to be referred to their local carer service.

If you discover that someone is no longer a carer, they may be finding life difficult, even if caring ended some time ago. If this is the case, we would recommend that a clinican should ask the carer how they are and, if necessary, screen them for depression, next time they visit the practice. Some carer organisations provide specialist support to bereaved carers so it's worth checking to see what's available in your own local area. Download the letter to patients already identified as a carer as a Word document.

What kind of services are available for carers?

Your staff may be unsure of what kind of services are available for carers and this may make them reluctant to engage with carers or encourage them to contact their local carer service. We have put together a flyer showing typical services for carers which we recommend you give to every member of your team, as well as to carers themselves.

Best-practice action plan

This diagram, showing the six steps to supporting carers has been adapted from Supporting Carers: An Action Guide for GP Practices and their Teams which Carers Trust co-authored with the Royal College of GPs. It illustrates the different ways GP practices can support carers, from appointing a member of the team as a Carer Champion to offering carers annual health checks.

Top tips in carer identification: What do carer-friendly practices do to find out which of their patients are carers?

  • They ask patients if they ‘look after someone’ instead of asking them if they are a carer because they know carers don’t always identify with the label.
  • They know which services are available to carers in their locality and use examples to encourage carers to self-identify.  
  • They know that posters and leaflets are not enough on their own to encourage carers to self-identify; that staff need to talk to carers as well. 
  • They have a carers notice board, but instead of calling it a carers notice board they fix a banner above it saying: If you look after someone, this is for you.”
  • They always have leaflets on display for carers at flu clinics and encourage staff to give them out to people accompanying patients to the clinic.

You can download the full list of suggestions as a top tips in carer identification.

Other useful documents

Demonstrating that a practice is caring.

Further information

For more details about how your local carers service can help you identify carers and offer them support, email Carers Trust

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