Recognition and support of ‘hard to reach’ carers Jill Pettitt Carers Project Worker PCT Liaison Wigan Council Carers Support Team – 2 nd February 2009

Recognition and support of ‘hard to reach’ carers Definition of a carer A carer is an unpaid person who provides regular and substantial care to an adult or child who suffers from physical / mental illness, frailty, disability or substance misuse Over a third of all carers reported that no one helps them care (general household survey) Between a quarter and a half of all carers have health problems of either an emotional or physical nature (Office of National Statistics 2001) Unpaid carers take on the caring role in response to the needs of the cared for person and are often unprepared for their caring tasks Carers carry out tasks without receiving appropriate training. 65% carers suffer from ill health or injury (PRTC) Saul and Becker describe young carers as “Permanently worried children” whose lives are seen as a cycle of crisis. Over 300 Young Carers have been identified in the borough of Wigan.

Recognition and support of ‘Hard to reach” carers Background The project began in June 2004 and was based on research previously undertaken by the Princess Royal Trust for Carers. (Primary Carers – Identification & Providing support to carers in Primary Care). This involved use of a three part model to aid the development of services for carers. Identification and referral – the initial stage involved developing a way of recognising a patient attending the surgery as a carer and developing a system to be able, if required to refer/signpost carers to relevant support. Identification and practice development work – this part of the model focuses on training within the practice to help staff support carers, raising awareness of issues affecting carers and systems to help carers. e.g. carer notice boards. Strategic work – this is the final stage and is the ongoing process of working in partnership with the PCT (Primary Care Trust) to ensure the long term development of recognition and support for carers within primary care.

Recognition and support of ‘hard to reach’ carers Aims of project The main aims of the project were to develop a service that would: Identify, recognise and register previously unknown carers Help PCT’s to set up their own carer register and be able to refer carers to appropriate support services To implement a tagging system within each GP surgery To identify training requirements for carers and services which may assist carers in their role

Recognition and support of ‘hard to reach’ carers Development of the scheme (1) Following research and evaluation with other authorities, a carer registration scheme was developed by use of a registration card and implemented in the 62 GP practices (now 73) throughout the borough of Wigan. A training manual entitled “Recognition of carers and young carers” for the use of GP’s and practice staff has been developed and provided to all practices. The project worker offers and provides carer awareness training, supported by a handout, on the recognition of hard to reach carers to all practice staff A notice board dedicated to carer information has been provided to each practice throughout the borough of Wigan and is kept updated by the project worker who also keeps the practices supplied with the carer identification cards

Recognition and support of ‘hard to reach’ carers Development of the scheme (2) A certification scheme award has been introduced to each practice to reward and encourage GP’s and practice staff to continue to identify hard to reach carers The certification scheme works on a “star” award For 0 – 10 carers identified - No certificate For 10 – 25 carers identified - Bronze star For 26 – 50 carers identified - Silver star For 51 – 100 carers identified - Gold star Some encouraging results have been achieved from a selection of GP practices as a result of this exercise

has been awarded a ………Star Rating Carer Awareness Commendation In recognition of its contribution to the awareness, support and understanding of carers issues through the GP Carer registration scheme Carers Support Team, Hyndelle Lodge, King Street, Hindley, Wigan. WN2 3AW Signed:Date: Team Manager – Carers Support Team This is to certify that

Recognition and support of ‘hard to reach’ carers General Positive Outcomes Where carers have been identified and records tagged, carers have reported that the regular acknowledgement of their caring role is valuable recognition, a visible sign of the importance of the carer It reflects well on the GP practice while boosting the self- esteem of the carer Carers who feel part of a healthcare team may be more likely to use the GP practice efficiently and are possibly under less stress than somebody who feels excluded Recognition and tagging provides a quick and easy referral system that enables carers to access information and support

Recognition and support of ‘hard to reach’ carers Profile Following the initial success of the registration cards, it was decided that an evaluation of the scheme was appropriate and a questionnaire was sent out to the first 290 carers registered. 250 carers returned the completed questionnaires and a report was compiled from the responses. The carer recognition scheme and subsequent results of the profiles link to Wigan Councils Carers Strategy Action Plan. In line with “Putting People First” and the personalisation agenda, the format of the profile will form the basis of a carer self assessment form.

Recognition and support of ‘hard to reach’ carers How do we support carers? Information & Advice Practical & emotional support Alternative therapies Carer Training courses Group support Fire risk assessments Returning to work Hospital discharge Bereavement and Loss support Advocacy Grant funding Primary Care Liaison Carer consultation Benefits checks Carer breaks Carers assessments Specialist support for BME carers through a BME Carer Support Worker.

Recognition and support of ‘hard to reach’ carers Progress up to February 2009 (1) 1805 Carers identified, 1131 profiles returned Involved in patient participation groups with a view to encouraging a carers support group within practices Carer training programme developed. Ongoing multi agency partnerships with Statutory and Third sector Carers referred to requested suitable services and grant applications GP Linkworker forum established with 10 other authorities in the North West to share good practice and learn from each other Carer fact sheet pack developed

Recognition and support of ‘hard to reach’ carers Progress up to February 2009 (2) Telephone consultation completed Carers are invited to “have a say” –Carers Consultation - development of new services for carers e.g. a new carers centre, reimbursement policy, carer strategy groups –Carer led Carer Forum to champion carers interests –Grant and interview panels, training, activity/event planning

Recognition and support of ‘hard to reach’ carers The future of the project (1) The project continues to grow as more carers are identified Carer registration cards are now available in many locations Expanding partnership working Health Ongoing work with the Pharmacies Expanding contacts with PCT Third sector

Recognition and support of ‘hard to reach’ carers The future of the project (2) Continue to raise awareness to carers about support and information access Attend information / awareness days Talk to support groups and identify new groups New carers centre due to be opened June 2009 Completion of Carers Directory Carers Emergency backup card Hospital discharge Carers hospital discharge fact sheet packs to be completed Provide information and training of carers to NHS & PCT staff

Recognition and support of ‘hard to reach’ carers Development of new services (1) Hospital Discharge project worker - : -Consultation with the Trust resulting in a carers phone kiosk and free phone number within the hospital -Carers information displayed on the hospital wards and clinics -Consultation with the Trust to establish recording carer status on paper & electronic medical files Emergency Card/respite scheme project worker – funding from DOH –Development of a Carers emergency card – Starting soon –Unique I.D. and phone no. Carers sign up to this so that in the event of an emergency there are arrangements in place to take over the caring role in the carers absence. Carers can nominate friends and neighbours to provide the care, If they can’t provide the care then a care provider is used. –Free for up to 48 hours

Recognition and support of ‘hard to reach’ carers Development of new services (2) Loss and Bereavement counselling service Ongoing support for former carers Development of Information Directory of services for carers Establishment of a new Third Sector Charitable organisation as an Independent Carers Centre for Wigan borough.

Recognition and support of ‘hard to reach’ carers Carers events and Contact details Carers Week Carers rights day Promotional / Awareness events Contact details Wigan Council’s carers support team Telephone: Office Hours:Mon – Fri 9am – 5pm Carers Helpline Available HoursMon – Fri 9.30am – 8.30pm