1. Surrey Community Pharmacy Conference Carer Awareness 13th January 2015

2. Aims for this session: Participants will have the opportunity to:
Introductions
Carer Awareness
Facts and figures about carers
Carers Rights
What services available in Surrey
How Community Pharmacy can support
carers?
Carer friendly pharmacy

3. Definitions of a carer ……
A carer is anyone who cares, unpaid, for a friend or family member who due to illness, disability, a mental health problem or an addiction cannot cope without their support. Carers are often required to administer medicines, and to order and collect prescriptions on behalf of the person they care for.
Who is not a carers
Paid Care Workers
Parents looking after non disabled children
Volunteer workers
Carers Trust

4. A Life Outside of Caring Surrey Carers Commissioning and Development Strategy 2016 -17 to 2018-19

5. Surrey Facts About Carers
108,000 Carers (9.6% of population). Breakdown:
78,920 provide hrs
11,039 provide 20 – 49 hrs
18,474 provide 50+ hrs (18.23%)
Young Carers – 3 in every room class
Every day 6,000 people take on caring responsibilities i.e million every year
6.5 million Carers -including 700,000 Young Carers
Takes on average 5 years for a carer to be identified
Over the next 30 years the number of carers will increase by 60% due to demographical changes and a rising older population.
National
Surrey

6. Demographics
Gender 58% Women – 42% Men Age Peak age for caring is 45– 65 years (working age) Ethnicity 9.2% of carers come from a BAME group
Black Asian and Minority Ethnic Group Carers have particular challenges around accessing support
Census 2011

7. Young Carers
A young carer is a child or young person under 18 who provides regular and ongoing care and emotional support to a family member who is physically or mentally ill, disabled or misuses substances. The term young carer does not apply to everyday or occasional help that may occur in all families. It is specific to care that is relied upon in maintaining the health, safety or day to day wellbeing of the person receiving support or care
Lets not forget Young Carers!

9. Money Talks:
How much do carers save the health and social care economy
Carers save the UK economy £132 billion per annum (Equivalent to NHS budget)
£1.8 Billion in Surrey
Each carer saves the state £18,473 annually in replacement care costs alone.
Baker Tilly Report - £1 invested nets £4 in health savings
75% of carers struggle to pay basic bills and 40% of carers report they are in debt due to their caring role
Valuing Carers – 2011
CIRCLE, Leeds University

10. Juggling work with care
In Surrey 60,000 people combine work with caring.
1:8 of the workforce are caring.
1:5 give up work to take on a caring role.
Recent report from the Alzheimer's Society states that 9:10 business say dementia caring is a growing issue for workforce.
On average, carers retire 8 years early, missing out on years of income and pensions contributions

11. Better Care Fund – NHS Contribution
GP Carers Breaks - £1,300,000.00
End of Life Carers Support - £300,000
Crossroads Care – Waiting lists - £300,000
Crossroads Care – Home based care - £156,000
Additional Carers Support Services - £205,263
Total- £2,261,263
Overall Total - £8m
Contribution to Surrey wide Joint carers contracts

12. Carers Health Caring can have a huge impact on the carers own health
In Sickness and Health Report (Carers UK 2012)
83 % of carers stated their physical health had been impacted
87% of carers said their mental health had been impacted with 40% being at risk of depression
80% of young carers experience mental health problems due to their caring role
The Surrey Adult Carers Health Survey 2011 and the Surrey Young Carers Survey 2013 provides a detailed analysis

13. Royal College of Psychiatry Report September 2014
Carers had poorer mental health and higher psychiatric symptom scores than non- caregivers. There was an observable decline in mental health above 10 h per week.
A twofold increase in psychiatric symptom scores in the clinical range was recorded in those providing care for more than 20 h per week

14. Carers UK – Carers A Breaking Point Report 10th September 2014
6 in 10 are at Breaking Point
A quarter of those who had reached breaking point required medical treatment as a result.
46% said despite being seriously ill they had no choice but to continue caring
1 in 9 said the person they cared for had to be rushed into hospital, emergency care or that social services had to step in to look after them while the carer recovered.
1in 5 were forced to give up their jobs because they were in crisis

15. Carers of People with Dementia
Family carers of people with dementia have difficulty managing their medication and lack the knowledge to weigh up risks and benefits of different drugs.
In July 2014 The Pharmaceutical Journal published an article revealing that Carers feel overburdened with the responsibility of administering medicines and think health professionals fail to understand the problems around managing medicines when caring for someone with dementia. Practical problems were often associated with drugs not linked to dementia. For example, the laxative Fybogel can set too quickly in a glass to be taken by a person with dementia.
analysis/news/carers-of-dementia-patients-reveal-burden-of- managing-medicines/ fullarticle?amp;amp;amp
The issues of medicine management are not emotionally neutral for carers.

16. End of Life Care – Advanced Care Planning
And what about the Carers?
Top 3 Concerns for Carers managing EOL at home
Managing Pain Relief
2. Not having Access to 24:7 Support
3. Strain on finances
End of Life Care

17. Legal Eagle Spot:
No adult is obliged to care for another adult, not even a spouse.
Parent carers have a duty to care for their own children under 18.
The right to a separate Carers Needs Assessment.
The right to have their views taken into account.
The right to services and support from the Local Authority if they have been assessed to have their own eligible needs as a carer
The right to be involved in the process of hospital discharge
The right to be supported to get back into employment or remain in employment.
Young carers have a right to services that supports them and enables them to live a full life, as well as protecting them from excessive or inappropriate caring responsibilities (Children's and Families Act)
And finally although not a right RCGP best practice is for carers to be registered with their GPs.
National Assistance Act 1948
Carers (Recognition & Services) Act 1995
Carers and Disabled Children’s Act 2000
Discharge from Hospital: Pathway, process and practice, Department of Health Jan 2003
Ready to Go 2010: Good practice guidance update
All supported by NHS Mandate and NHS Constitution
All supported by The Surrey NHS Carers Care Pathway
NHS and Community Care Act 1990
Community Care Directions 2004
Mental Capacity Act 2005
Employment Relations Act 1999
Carers Equal Opportunities Act 2004
Work & Families Act 2006
The Equality Act 2010

18. Why Carers are so important to NHS Health Services?
They help us:
Reduce admissions to hospital and residential care.
Reduce the costs of delays in transfers of care.
Reduce carers’ need to access primary care as a result of their caring role.
Reduce overall spending on care

19. What do Carers want from the NHS?
Identification and Recognition
Involvement in Care Planning
Accessible Information
Referral to Carers Support Services
A whole family approach
Training
Protection
Choice
Key components of the National Carers Strategy 2010
Carers know the ‘cared for’ person far better than any health practitioners
Carers need to be treated as expert partners
Surrey Carers Care Pathway

20. Surrey Carers Care Pathway
Co-designed ‘Carers Care Pathway’ linked to patient care pathways and hospital discharge procedures.
The aim is to support heath staff in identifying, recognising and supporting carers (including young carers).
Training resources and a practitioners check list have been developed to work alongside the model.
A new fast track referral process is being developed for launch 2014.
Website:

21. Refer Carers for Carers Assessment and other Carers Support Services
Identify Carer/s
Recognise carers needs and refer them for their own support needs and to validate including young carers.
Think Families!
Provide Carers information about Surrey including Young Carers Service
Use carers pathway (Parental consent required for those under the age of 16 years)
Refer Carers for Carers Assessment and other Carers Support Services
If person using services gives consent then involve the carer in care planning

22. What is a Carers Assessment?
A Carers Assessment is the legal right for the carers to have an assessment of their own needs. It is a chance for the carer to discuss with the social care team, what help they and/or their family need in their caring role.
Here is a list of things that might be discussed:
Is the Carer willing to care?
 Is the Carer struggling to find any/enough time for themselves,
Are they able to get out and about,
The affect caring is having on their health,
how caring is affecting their relationships with others,
whether the person they're caring for is getting enough help,
sources for additional help via local or national support organisations,
and any employment concerns they may have

24. What's Available in Surrey?
10 Carers Support Organisations that are borough and district based. They provide advice, advocacy, information and support.
Surrey Crossroads – Generic Home Based Care and EOL Carers Support
Surrey Welfare Rights – Benefits Advice
Action for Carers Surrey – Young Carers, Back Care, Work and Training, GP Carers Awareness Advice, Giving Carers a Voice
In all last year we supported 22,000 carers here in Surrey

25. Surrey GP Carers Registration 2015
Approx 20% of adult carers are now registered with their GP
Less than 0.1% of young carers are registered

26. Carers Health Checks in Partnership with Carers Support
425 checks have been offered
338 health checks to carers:
Take up rate is 79.5%.

27. Surrey Carers Emergency Card
Surrey County Council has an Emergency Carer’s Card which Carers carry with them at all times. If they are taken ill or are in an accident, this can alert the emergency services to their caring responsibilities.
Linked to this Carers can register details with Surrey County Council about who they care for and what measures need to be taken if they are suddenly unable to continue in your caring role so that emergency provision can be made. These cards are available as part of the Carers Prescription.

28. Surrey Young Carers
(SYC) has been supporting young carers, under the age of 18, across Surrey since 1996.  They offer free impartial information and support to young carers and their families on minimising the impact of their caring role.
They provide workshops, forums, activities and groups.  SYC gives young carers timeout from their caring role and helps them to achieve their full potential.  They promote the needs of young carers in all child care and adult settings, they offer training to Health, Social Care and Educational professionals. SYC is currently working with 1600 young carers.
Surrey Young Carers Astolat, Coniers Way Burpham, Guildford, GU4 7HL Contact or Visit

29. Surrey Facts About Carers
108,000 Carers (9.6% of population). Breakdown:
78,920 provide hrs
11,039 provide 20 – 49 hrs
18,474 provide 50+ hrs (18.23%)
Young Carers – 3 in every room class
Every day 6,000 people take on caring responsibilities i.e million every year
6.5 million Carers -including 700,000 Young Carers
Takes on average 5 years for a carer to be identified
Over the next 30 years the number of carers will increase by 60% due to demographical changes and a rising older population.
National
Surrey

30. Partnership working with Carer support groups
Acute Trusts
Patient and carer
Information boards.
Partnership working with Carer support groups
NHS Providers have a key part to play in supporting carers.
A CCG can ensure this by referencing carers in all commissioning intentions and contracts.
A Surrey Wide Carers and NHS providers network meet quarterly to share best practice and monitor the implementation of the Surrey Carers Strategies.
Training
Documentation 3

32. Carers and Pharmacy Week 2015
Aim is:
To increase the identification and support of unpaid carers (including young carers)within a community pharmacy setting so that carers receive support before they reach crisis point.
To improve pharmacists awareness of carers
To work in partnership with carers to support medicine management and reduce waste.
To evaluate the impact the promotion week has had and report back to commissioners
Approx 50 Pharmacists took part

33. Carers and Pharmacy Week 2015
Pharmacies hold a unique position in terms of their accessibility, the frequency with which many carers visit their local pharmacy and the supportive and professional relationship they develop with regular customers. 
This position puts them in a strong position to support carers – not only for their ability to provide a range of advice and healthcare services, but also to be able to identify carers and refer them on to GPs and local carers services

34. Carers and Pharmacy Week 2016?
Date to be determined
In Partnership with Crossroads Care Service
Posters
Carers Information Leaflets
Carers Postcards
Carers Emergency Cards
Carers Prescription
In 2013 we mailed out resources to every pharmacy
In 2015 we invited pharmacy to opt in
2016…..?

35. Steps to become a Carer Friendly Pharmacist
Ensure all staff are trained to be carer aware, sensitive to carers’ needs and the challenges they face and understand the best way to engage effectively with carers.
Ensure all staff are pro-active in identifying, referring and supporting carers.
Identify a member of the team to take on the role of ‘Carers Champion’, to lead and facilitate carer referrals and act as a contact point for the local carers services. 
Display posters and leaflets to encourage carers to self- identify
Safe guard young carers

36. Want more? Carer Awareness Training
There are lots of choices to staff: Basic E Learning is available: There are also half day courses provided by Action for Carers Surrey. Carers Trust Training and Resources
Action for Carers Surrey – BCC count training and whole family assessments

37. Here for Carers – Welsh Pharmacy
The campaign ran throughout October online and in pharmacies across Wales
Carers are often required to administer medicines, and to order and collect prescriptions on behalf of the person they care for. To ensure carers take advantage of the support offered by pharmacists
A free bilingual booklet ‘A Carer’s Guide to Managing Medicines’
e-carers-campaign-raises- awareness-carers-amongst- pharmacists

38. Next Steps: How can we support you
Next Steps: How can we support you? - Piloting Carers Prescription - Crossroads Care Surrey – Carers Information Week 2016

39. And always remember it could be you!
Prepared Debbie Hustings
Partnership Manager for Carers
Mob:
(Mon – Wed)
Ron Critcher
Carers Lead – Surrey County Council
Telephone: