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Nigel's surgery 44: Caring for carers
We have updated this issue of Nigel's surgery to include 'Supporting carers in general practice'.
Carers make a significant contribution to the health and care system.
Our report Beyond Barriers describe how carers have pivotal roles in supporting their families and loved ones to remain independent and well. As well as providing care, unpaid carers navigate systems and coordinate care and support around the person they care for.
Who are carers?
Carers UK estimate that there are around 7 million carers in the UK, meaning carers represent 10% of the UK population. This includes around 700,000 young carers (aged 17 or below).
A carer is a person of any age (including children) who provides unpaid support to a partner, relative, friend or neighbour who couldn’t cope without their help. This could be due to old age, frailty, disability, a serious health condition, mental ill health or substance misuse. Parents of children who are disabled or who have a serious health condition are also considered to be carers.
There is a difference between a carer and care professionals paid to provide care. Some carers receive statutory payments (for example Carer’s Allowance) or a direct payment for their caring role. Even when carers receive such payments, they are still considered to be carers.
However carers are not always identified by their GP practice and there are several reasons why. One is uncertainty around the definition of the term ‘carer’. Also, many carers may not readily identify themselves as a carer. Instead, they see themselves as someone’s partner, relative or friend who is simply 'doing their best' to help someone they care about. For this reason, asking 'do you look after someone?' can be a more effective opening question than 'are you a carer?'
Challenges carers experience
Carers can face many challenges in their caring role. For example, carers can feel unsupported if they are unclear about where to go for information to support them.
Young carers may experience educational difficulties. This includes absence and lateness, poor concentration and low attainment. Carers aged 16 and 17 are less likely to be in education, training or employment.
Some adult carers give up paid employment to provide care. They may have to borrow money or use savings to cover the costs of caring. The Office for National Statistics estimates the cost of replacing unpaid carers with paid carers in the UK as £57 billion per year.
This recent NHS England publication provides a framework for how general practice can better identify and support carers. It was developed in partnership with carers, primary care teams and other stakeholders, including CQC.
The quality markers ask a general practice to identify six things. How they:
- identify and register carers
- use the carer’s register to support holistic carer health and wellbeing needs
- organise themselves to understand and respond to the needs of carers
- make it easier for carers to access services
- communicate with, involve and inform carers
- promote a carer-friendly culture
These quality markers could be a good way to show how you identify and support carers at inspection.
Identify, assess and support carers’ needs, and so reduce:
- avoidable demand on services and meet demand more appropriately
- carer ill health and promote positive carer health and wellbeing
- carer and family breakdown
- unwarranted variations in carer support
The Commitment to Carers reflects what carers say is important to them:
- recognising me as a carer
- information is shared with me and other professionals
- signpost information for me and help link professionals together
- care is flexible and available when it suits me and the person for whom I care
- recognising that I may need help both in my caring role and in maintaining my own health and well-being
- respecting, involving and treating me as an expert in care
- treating me with dignity and compassion
These include ‘Involving and supporting carers and their families’, an educational framework and learning resource.
This set of resources is for everyone who works with carers and highlights the importance of:
Improving carer identification
- nominating a lead person for carers
- asking patients with long term conditions to identify their carers
- running awareness-raising campaigns to get carers to self-identify
Improving health care
- flu vaccination
- screening carers regularly for depression and other health problems
- offering flexible appointments for carers
- carer support groups or advice surgeries
- surveys to gather carers’ feedback about services and their satisfaction with them
- referrals to carers services for more specialised information, advice and support
When we inspect
We look at how effectively carers are supported when we consider the key lines of enquiry:
- C2: involving people in decisions about their care
- R1: how do people receive personalised care that is responsive to their needs?
We may ask questions about how practices support carers:
- carers registers
- holistic support needs
- in-practice support
- appointments and access
- information for carers
- awareness and culture
Examples of outstanding practice: Involving people and caring for carers.
- Carers Trust: GP practice quick start toolkit
- Carers UK website
- NHS England carers toolkit
- NHS England commissioning for carers
- RCGP carers support resources
Contact the Carers Trust’s primary care team at for further information and local support.
- Last updated:
- 22 August 2019