Introduction

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, 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 being someone below 18, who carries out significant caring tasks and by so doing, 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, or 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.

Protocol

It is important to estimate the total number of carers within your practice catchment area.

• 10% of the population are likely to be carers
• 34% of those carers are likely to be caring for 20 plus hours a week
• 11% of those carers are likely to be caring for 50 plus hours a week

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 and 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
• Undertaking a carers audit to track progress and to evidence the work conducted in line with good practice guidelines

Identifying Carers

There are two proven methods of identification:

• Self-identification
• Pro-active practice identification

The practice undertakes the following activities as part of each method.

Self-Identification

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.

Prescriptions

A message is attached to repeat prescriptions requesting appropriate patients to complete the carer-referral form.

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.

Prescriptions

A person who collects a prescription on behalf of someone else, may be passed a carer-referral form.

Health Professional Identification

All health professionals in the surgery complete referral forms when they ascertain a patient is a carer.

This is regularly discussed at multi-disciplinary team meetings to exploit personal knowledge.

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 ub1ju 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 that they may 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 carer’s name and contact details

Competency

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

Once the carer identification referral form is completed it is handed to the medical secretary for scanning then forwarded to Emma Weatherley for coding and forwarding to Carers MK.

The following read codes are used to tag carers notes:

• Carer – ub1ju
• Has a Carer – 918F
• No longer a carer – Y3222

When the details on the form have been entered on to the patients’ notes, the referral forms are to be copied and sent, as appropriate, to:

Carers Milton Keynes,
Margaret Powell House
439 Midsummer Boulevard,
Central Milton Keynes,
MK9 3BN

Tel: 01908 231703
(calls charged at local rate)

Email: mail@carersmiltonkeynes.org

Please refer to “carer’s supporting evidence” document which contains the following documentation to support this Policy:

• Carer’s support policy
• Carer’s identification and referral form
• Letter to carers and referral Form
• Poster
• Agreement by a patient to allow a carer to have access to their personal details and / or copies of correspondence
• Contact points