NHS sets out ‘care for young carers’ offer in GP surgeries

NHS England has outlined a series of practical plans and actions designed to help young carers who may be ‘hidden’, unpaid and under the age of sixteen.

Coinciding with the health theme day of Carers Week, from Tuesday (June 11) family doctors across the country can volunteer to offer a new package of services for children and young adults who perform an informal caring role for a family member.

This includes priority appointments for carers, home visits, additional mental health checks, and ‘double appointments’ for the carer and those they provide care for.

‘The challenges facing young carers have recently been brought to life by Eastenders character Bailey Baker, a nine-year old who cared for her mother, who suffered with multiple sclerosis before taking her own life.’

Research from Barnardo’s and Carers Trust has highlighted a host of challenges young people face in juggling their caring role with their education and own health, with up to 40% experiencing mental health problems.

The measures, backed by Carers UK, Carers Trust, CQC and the Children’s Society, mean GP practices may offer more tailored services for carers in their community, based on national proposals and assessed against six ‘Quality Markers’, to ensure carers in every community across the country are being offered high quality support by their local practice.

It is estimated that up to one in five secondary school pupils provides some level of care for a parent or sibling.

Many of these are ‘hidden’, not disclosing their family circumstance and responsibilities to teachers, friends, GPs and other health care professionals.

Plans are also underway for young carers themselves to develop ‘top tips’ for GPs to help 20,000 young people benefit from more proactive care, as set out in the NHS Long Term Plan.

The top tips will be designed by a diverse group of  ‘health champions’ – young carers selected from around the country – and ideas and feedback on what should be included will be given by some of the 1,800 young carers attending the Children’s Society Young Carers Festival in June.

Dr Neil Churchill, director for experience, participation and equalities at NHS England, said: “Thousands of children and young people provide nothing less than life-changing care for their family and deserve in return the best possible support from the NHS and other public services. No young carer should feel they are struggling to cope on their own.

“The responsibility of giving care can take a real toll and our Long Term Plan will deliver care for carers that matches the commitment so many young people give their family day in, day out.”

Giles Meyer, CEO of Carers Trust, said: “Young carers routinely tell us that GPs often fail to recognise the health problems that arise from their caring role. That’s where these Quality Markers come in. They have huge potential to really help GPs identify and support carers of all ages within their practices, as well as refer them to specialist support in the community.”

Helen Walker, Chief Executive of Carers UK, said: “Unpaid carers are often able to convey a lot to professionals about the health of the person they’re looking after, but sometimes feel their role isn’t fully recognised and are unaware of the support they’re entitled to as a carer. Usually putting their own needs second, their health and wellbeing is often left at risk when they do so much to support others.

“Identification of carers of all ages by NHS staff could make a real difference. These measures should help get more carers connected to the right support, as well as help them with important contingency planning for emergencies.”

All GP practices in England will be invited to adopt dedicated measures for carers in their community, including:

  • Keeping an up to date carers register, to routinely offer all carers a flu vaccination, regular health check and anxiety and mental health screening;
  • Setting up an alert system to notify all GPs when a carer registers as a patient, to ensure their needs are identified and met by the whole surgery;
  • ‘Double appointments’ – carers being offered an appointment themselves to get physical and mental health checks when they come to the surgery with their cared for relative;
  • Hosting carer support groups and carer clinics in GP surgeries, so young people can get practical carer and health advice at the same time, with other carers;
  • ‘Carer awareness’ training will be included in every surgery staff induction;
  • Practices setting up systems to track patterns of appointments in young people coming to the surgery with an adult, to proactively try to identify young carers and put support in place.

Surrey Heartlands was the first Integrated Care System in the country to pilot the GP Carers Quality Markers in March 2019, and since then 76 out of the 90 practices in the area have taken up the option to include the quality markers for CQC inspection.

Dr Claire Fuller GP, Senior Responsible Officer of Surrey Heartlands ICS said: “Surrey Heartlands is delighted to have been a pilot site for the new GP Carers Quality Markers.

“Our Annual GP Carers Registration Survey Report 2019 shows that 76 practices across Surrey completed the new Quality Markers which in turn provide an important evidence base for their CQC inspection. Far more important though the Quality Markers offer a practice an opportunity to bench mark the support they offer to carers which in turn encourages them to be more consistent and build on best practice.

“An example of this is that in Surrey 58 practices are now offering carers double appointments recognising this allows carers a better opportunity to address their own health concerns as well as allowing the GP to provide them with a Carers Prescription. Another example is around supporting practice staff who have caring responsibilities. 50 practices are already doing this and we will shortly be sending them information on how they can register with Employers for Carers Services so they can continue to build on the support they already provide”

Around one in ten people – an estimated five million people – is an unpaid carer, with one in five of those providing more than 50 hours of support every week.

Barnardo’s Chief Executive Javed Khan said: “Barnardo’s recognises that family doctors play a crucial role in identifying and supporting the thousands of children who care for unwell and disabled relatives.

“We welcome new proposals from NHS England – including giving priority to young carers in booking appointments, extra time with doctors and additional mental health checks, which could help these young people manage their caring responsibilities.

“Our latest report highlights how Black, Asian and Minority Ethnic (BAME) young carers are often ‘hidden’ from services and are even less likely to access support, so these changes could make it easier for them to get the help they so desperately need.”

The NHS is also working with young people to develop ‘top tips’ for GPs, which will address areas such as how to identify young carers, talking to them about looking after their own health, and how they can support them through social prescribing – helping them to access local clubs, support groups and respite services.

Helen Leadbitter, Area Manager and National Young Carer Lead at The Children’s Society, said: “The festival provides young carers with a unique opportunity to meet key decision makers, to tell them directly what support they need and what can be done to make their caring responsibilities more manageable.

“These top tips for GPs demonstrate just one of the many ways young carers are being listened to. Since the festival began in 2000 we have been able to change a number of policies for the better and we are confident this year will give a new group of young carers a chance to be heard.”

As part of the Long Term Plan the NHS has pledged that up to 100,000 carers of all ages should have back-up support in place for emergencies and that health and care professionals are aware of what to do and who to contact if needed.

NHS England and Improvement are also supporting the rollout of carers’ passports which offer rights, support, discounted parking and catering, to improve the recognition and support of carers of all ages in hospitals.