Healthcare :: Financial cutbacks are hampering the vital support doctors can give carers, says BMA

Doctors want to work more closely with carers in their communities but are being hampered by financial cutbacks, says the BMA. Updated guidance from the BMA?s Community Care Committee published says extra resources would help GPs identify more carers.

Dr Helena McKeown, chairman of the BMA?s Community Care Committee says: ?Identification is a vital first step in ensuring a good working relationship which benefits both the carers and those they look after.?

The guidance is supported by HRH The Princess Royal, the new President of the BMA, whose organisation ?The Princess Royal Trust for Carers? is the largest provider of support services for carers in the UK.

There are over six million carers in Britain. Each year nearly 2.5 million people will start or finish caring, which means identifying new carers is a continual process. However, they can be a difficult group to recognise as many carers are reluctant to acknowledge their role and feel that asking for outside help could be seen as failure.

Carers are more likely to suffer emotional or stress related illnesses or sustain physical injuries as a direct result of looking after someone. This means their first point of contact is often with the NHS, in particular their GP. Doctors are therefore in a prime position to act as signposts, directing carers to the services available to them.

The BMA guidance says the new GP contract has been a huge success in incentivising those practices choosing to take part in extra quality initiatives to develop protocols to identify carers. Since 2003 many GP practices have chosen to introduce a voluntary identification scheme. Yet turning these into formal registers would require extra resources. However, this would be of benefit not only to the patient, but it could also lead to shorter appointment times, a reduced number of inappropriate queries and potential reductions in GP prescription costs, for example, antidepressants.

A formal register could become a valuable tool to improve carers? and patients? well-being says the new guidance, but would only work if Primary Care Organisations and Local Authorities prioritise the resourcing of formal carer strategies for Practices.

The BMA guidance suggests a formal carer strategy could include:

Having a specific named contact for carers ? a member of staff or visiting support worker.
Using carers or ex-carers to provide a ?listening ear? for new carers.
Providing a carers literature rack in surgeries or clinics and posters outlining services and benefits that are available.

It lists other work that could be done but where extra investment would be necessary to allow that to happen. For example, a practice could provide ?clinics? for carers comparable to baby clinics with a doctor, nurse, health visitor, social worker and occasionally a representative from social security or the Inland Revenue. Yet, it says, the successive loss of traditional Primary Care Teams means that such strategies are now going to be more difficult to achieve without additional investment.

The guidance also offers advice to professionals working in hospitals as research shows a significant number of carers feel their role is not properly recognised by hospital doctors, particularly when a patient is discharged. It recommends carers are involved in the planning of future care when a patient leaves hospital so assumptions are not made about what care they can provide.

Dr Helena McKeown, herself a GP said:

?It is important doctors work as part of a team with other health professionals and organisations in developing any strategy for carers. They should not feel they have to do this on their own. As doctors we are in a great position to really improve the lives of a group of people who are often reluctant to ask for help.

?Identifying and working more closely with carers in this way would not only really make them feel supported, but it also has the potential to reduce hospital admissions for carers and for the cared person. This is an excellent use of NHS monies.?

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