Many carers need greater support from their GPs
Our Report, Carers’ Views and Experiences of Accessing Support from their GP Practice, showed some local GP practices did offer good support to carers - from identifying and registering them, to providing a Carer’s Champion, additional help, health checks and flexibility when making appointments – but many others still needed improvement.
Local NHS leaders are considering the Report’s recommendations. These include ensuring each GP practice has a Carer’s Champion and better recognition of patients who are carers, so they can register for services that would benefit them and the person they care for.
Why did we do this research?
The Hertfordshire and West Essex Integrated Care Board (ICB) Primary Care Board asked Healthwatch Hertfordshire to gather feedback from carers living in Hertfordshire. Specifically, the ICB wanted to know whether carers were registered as a carer with their GP practice and how GP services supported local carers. We also carried out an audit of all GP practice websites to find out if they provided information about how to register as a carer and the benefits of registering.
More than 600 carers shared their experiences during our three-month survey and highlighted just how difficult their caring responsibilities could be and how important it was that they received support from GP services.
What did carers tell us?
- Only 23% of respondents described the support they received from their GP practice as “good” or “very good”, while 34% described the support as “bad” or “very bad”. Feedback varied considerably:
“I find our surgery to be very unaware about the stress and anxiety that carers suffer. I dread getting in touch with our practice these days as I fear I will be told more of what they can’t do than what they should do. The stress of caring has multiplied. Our GP surgery used to be the one place where I felt assured of some extra help. If I need (not want) help from our surgery, sometimes, I have to really stand my ground.”
“I’m very lucky with my GP he is outstanding. He has supported me with my husband over the past 16 years and my daughter over the past 9 years. They both have complex medical conditions.”
- 68% were formally registered as a Carer with their GP practice, but lack of awareness about the importance of registering was the main reason why many were not. 86% of carers who were not formally registered with their GP practice said they would register - if given the opportunity and/or support to do so.
“This prompted me to call my doctor. I have now been asked to email the surgery asking to be registered as a carer which I have now done.”
“I didn’t realise it was something that I should do. I just assumed that if they knew I was caring for my elderly mother with Alzheimer’s that was sufficient.”
- Only 13% knew if their GP practice had a Carers Champion, although 63% would seek support from a Carers Champion if given the opportunity.
“GPs don’t have a huge amount of time to spend with patients whereas Carers Champions can talk to carers holistically about the whole picture. The Carers Champion can identify where the GP can be most effective and look at ways other people might be able to help.”
- 57% of carers said it was difficult to get through to their GP practice, 29% did not have the time to access their GP practice and 29% said it was hard to fit appointments around their caring and/or work responsibilities; 76% had not been offered greater flexibility when booking an appointment for themselves, or someone else, and said being registered as a carer made “no difference.”
“Be more flexible when booking appointments and understanding that we can’t call first thing and drop everything that same day to go to an appointment – it needs to be planned. And don’t cancel last minute when we’ve put a lot of effort and resources into attending the appointment.”
- 75% of carers had been offered an annual flu vaccination – but only 17% were offered an NHS Health Check and 16% offered a Carer Assessment and/or benefits check. 87% had not had their physical or mental health examined in relation to their caring role and 22% had not been offered any support, while 72% were not aware they could even access support from their GP practice. 79% had not received any signposting information and only 12% had been encouraged to speak to a social prescriber. Again, feedback varied:
“GPs need to be more aware of the huge burden/stress etc of being a carer has on mental health and well-being, ability to earn/work, reduced social opportunities, loneliness, isolation, etc.”
“I recently made an appointment to discuss health concerns exacerbated by my caring role and was treated very sympathetically and supportively.”
Examples of good practice were highlighted, with some carers praising their GP practice for being supportive, responsive and offering greater choice and flexibility to help accommodate their caring responsibilities and/or the needs of the person they care for.
“One of the GPs has provided brilliant support for me in getting help for my son. I have received excellent support when I have approached for help with my mental health. Twice I have received a same day appointment. One GP after discussion supported a request to my employer for a month of reduced hours which helped me through an extremely challenging period.”
“They are always kind, considerate, and helpful. When I'm upset they give me time to say/explain/ask what I need to. If the person I'm talking to cannot help they will always find someone that can, even if that's a call back phone call. They are willing to go above and beyond to help me as a carer.”
Key findings from our website audit included:
- 81% of websites had information about how to register as a carer and 73% explained why this was important.
- 75% of websites had a form patients could fill in to register as a carer
- 58% of websites did not explain what a carer was and only 63% explained the support carers should be entitled to; 25% did not provide this information at all.
- 91% of websites had signposting information for carers but most information was generic and not local.
What happens next?
Our Report shows that support for carers varies widely between GP practices. However, many carers who responded to our survey said they would like GP practices to show greater compassion, understanding and empathy. They said staff and clinicians should acknowledge the pressures and responsibilities carers face and how this can impact them emotionally, physically and mentally.
Our Report has recommended:
- Many carers do not identify themselves as a carer, so don’t receive the support they should. GP practices are often a first point of contact for carers and should ensure carers identify and register themselves. Consideration should be given to language, as many people do not resonate with the term “carer.” Staff should also avoid making gendered or cultural assumptions about caring.
- Each GP practice should have a Carers Champion to ensure carers feel supported.
- Carers need improved access to their GP, whether this be for themselves or the person they care for. This includes more choice and flexibility in appointments including “double appointments” when necessary and staff being more mindful of caring responsibilities and demands when offering appointments.
- Those registered as a carer should receive additional support from their GP practice to help manage their own health and wellbeing. This includes NHS annual health check (with a thorough examination of physical and mental health), flu vaccinations, carer assessment and benefits checks. Signposting to local support should also be offered.
