Support for carers – how community pharmacy teams can help
Support for carers – how community pharmacy teams can help
PSNC has produced Briefing 001/15: Support for carers – how community pharmacy teams can help, which complements this webpage by providing more detailed information on the important role that carers play in supporting patients and the NHS and explains how community pharmacy teams can help carers in their work.
Research published on the Carers Week website in June 2015 showed that carers rate pharmacy as the most carer-friendly service they receive out of all community services across health, social care, work, transport and education.
Carers were asked which health and social care services in their local communities were the best at meeting their needs and which services failed to include them; pharmacies came out on top as the most carer-friendly services overall:
- 67% of carers rated the pharmacy as carer–friendly; and
- Only 8% of carers rated the pharmacy as not carer-friendly at all.
Who is a carer?
A carer is a person who provides unpaid care for a family member, partner or friend who cannot cope without their support due to an illness, frailty, disability, a mental health problem or an addiction.
The term ‘carer’ is sometimes confused with a care worker or care assistant; however, the difference is that a carer is unpaid whereas a care worker or care assistant is paid for looking after someone.
The sort of roles and responsibilities that carers provide can vary greatly. It can range from help with everyday tasks such as helping someone get dressed and personal care such as bathing, to emotional support such as helping someone cope with the symptoms of a mental illness or an addiction.
Sometimes people refer to carers as full-time carers or part-time carers; however, there is not a minimum time requirement that means they are more or less of a carer. There is also no minimum age restriction on what “qualifies” someone as a carer.
There are nearly 7 million carers in the UK; almost 5 million of these people are carers in England.
NHS England & Department of Health and Social Care publications
NHS England and the Department of Health and Social Care (DHSC) have published a number of documents, which acknowledge the great job that carers do and recognise how important they are to the NHS. The key documents that have been published since 2014 are:
- Carers action plan 2018 to 2020 – The plan sets out how the government will improve support for carers in England over the next 2 years.
- NHS England’s commitment to carers – NHS England has developed a list of 37 commitments of action to take forward to support carers and the people they care for.
- Department of Health and Social Care Carers Strategy: Second national action plan 2014-16 – Provides an overview of the evidence and main achievements in recognising and supporting carers during the last few years as well as the four priority areas for DHSC to focus on over the next two years.
- The Commissioning for Carers: Principles and resources to support effective commissioning for adult and young carers – A practical tool which forms part of a suite of products that will help commissioners to deliver what carers say is important to them in ways that have been shown to work effectively and efficiently in practice. It is based on ten principles to deliver better outcomes for carers, patients, commissioners, practitioners and local communities.
- An integrated approach to identifying and assessing Carer health and wellbeing – The toolkit covers new duties on NHS organisations brought about by the Care Act 2014 and the Children and Families Act 2014, and includes numerous examples of positive practice that are already making a difference to Carers and their families. NHS England has also produced an animation, which provides an overview of how NHS England hope the integrated approach will make a difference to carers and their families.
Carer support organisations
There are two main charities that support carers, Carers Trust and Carers UK. Both organisations provide expert advice, information and support; connect carers with groups and volunteers; campaign on behalf of carers and work with local authorities and organisations to improve services throughout the UK.
Both organisations are also very active on social media and can be followed on Twitter @CarersTrust @CarersUK and both have Facebook pages.
How can pharmacy get involved?
Community pharmacy teams have always provided support for carers via the wide range of services they provide. This support, such as practical assistance to order and collect prescriptions from GP practices, delivery of medicines to people’s homes and helping people to manage their medicines use, via multi-compartment compliance aids, as well as signposting to support organisations, has often been provided, without consideration of whether a person is a carer; these are simply services that are offered to those with a need for support. However, these are services that can have a massive impact in assisting carers, therefore, the need to identify carers and tell them about the services available in the pharmacy and signpost them to support organisations is extremely important.
PSNC has produced two template leaflets for pharmacy contractors to use to assist them in advising carers on the services they offer and to provide information to carers on managing medicines.
Carers Leaflet – Pharmacy Services (Microsoft Word)
Carers Leaflet – Managing Medicines (Microsoft Word)
Cares Trust has produced a flyer (Microsoft Word) detailing the help available for carers from their organisation. Contractors can insert their pharmacy logo or contact details on the second page of the flyer to distribute to carers.
NHS England’s Commitment to Carers stated that 70% of carers come into contact with health professionals yet health professionals only identify one in ten carers and that 66% of carers feel that healthcare staff do not help to signpost them to relevant information or support. When information is given, it comes from charities and support groups. This shows there is a big opportunity for pharmacy teams to contribute to identifying carers and signposting them to the information and support they need.
Recent examples of how community pharmacy teams are getting involved are listed below.
Flu vaccination service
Carers are included in the group of patients eligible for an NHS flu vaccination under the national flu service but it can be difficult to identify who is a carer. Resources to assist pharmacy teams in identifying carers can be found on the Identifying carers eligible for a flu vaccination page.
The Carer-Friendly pharmacy pilot – 3rd November 2014 to 28th February 2015
The Carer-Friendly pharmacy pilot, led by Carers Trust and PSNC, is part of a programme of work funded by the DHSC and forms part of the ‘Supporting Carers in General Practice Programme’ involving Carers Trust, the RCGP and Carers UK.
A total of 44 pharmacies are involved across nine Local Pharmaceutical Committee (LPCs) areas.
The aim of the project is to increase the identification and support of unpaid carers within primary care and community settings so that carers receive support before they reach crisis point. The project tests the concept of a ‘Carer-Friendly Pharmacy’, which pharmacies participating in the project will seek to become.
A Carer Friendly Pharmacy is one where:
- all staff are trained to be carer aware, sensitive to carers’ needs and the challenges they face and have developed enhanced communication skills to enable them to engage effectively with carers;
- all staff are pro-active in identifying, referring and supporting carers;
- the pharmacy identifies a member of the team who takes on the role of Carers Champion along with a deputy – their role is to lead and facilitate carer referrals, act as a contact point for external agencies such as the local carers centre and GP practices to support a multi-disciplinary approach and to maintain stocks of resources;
- posters and/or related materials make it clear to the customer that the pharmacy is carer-friendly and encourage them to self-identify; NB. It is acknowledged that displaying materials will be easier in larger pharmacies and Healthy Living Pharmacies where there is a dedicated notice board to display such information;
- the pharmacy offers a range of services, such as Medicines Use Reviews (MURs) and prescription collection and delivery, in a manner that is relevant to the carer; and
- with the carer’s consent, the pharmacy will refer the carer to their local carers services and/or their GP. In the pilot the PharmOutcomes system is being used to make these referrals and capture information on the referrals to allow evaluation of the service.
The core model may, in some localities, be augmented by add-ons such as pharmacy delivery driver engagement with carers, pharmacy-based carers’ health checks and free flu vaccinations for carers where the pharmacy has been commissioned to do so.
Below are resources used to support the Carers Trust/PSNC Carer-Friendly Pharmacy pilot:
About the Carer-Friendly Pharmacy Pilot
CPPE and Carers Trust training
The project is showing promising results as reported on the PSNC website on 27 January 2015.
An evaluation of the service has been published by the Centre for International Research on Care, Labour and Equalities (CIRCLE) at the University of Leeds.
Devon Carers – Carers Health and Wellbeing Checks
Pharmacy teams are involved in another service in Devon, the Carer Health and Wellbeing Check service. This service is offered in a number of participating pharmacies and GP surgeries and is particularly aimed at adult carers between the ages of 40-74 and carers at risk of admission to hospital (or if they are caring for someone at risk of admission to hospital).
The Carer Health and Wellbeing Check service, which offers carers an hour of protected time, provides a free and confidential check-up covering elements of the NHS Health Check, where appropriate, and a wider review of the carer’s health, wellbeing and home environment. It also offers the carer the opportunity to raise any worries or concerns they may have about their health.
If a carer is unable to visit the pharmacy or GP as they cannot leave the person they care for, it may be possible to arrange for the Health and Wellbeing Check to be carried out in the patient’s home. Alternatively, there is money available to pay for someone to look after the person being cared for while the carer has their check.
A plan is developed with the carer and this will incorporate referral to other services where required. A follow up review is then offered to the carer six months later.
The service ran as a pilot during 2010-11 before being commissioned by NHS Devon in 2011. LPC members can view the evaluation of the pilot scheme on the PSNC services database (please note LPC members should log in to the LPC members section of the website prior to searching the database in order to access this information).
Further information on the service can be found on the Devon Carers website.
PSNC Briefing 047/15: Supporting frail, vulnerable and older people to live independently (August 2015)
This PSNC Briefing provides background information and statistics on the challenges people face in managing their medicines; and provides examples of locally commissioned pharmacy services which are supporting and empowering people and their carers to manage their medicines, while assisting them to live independently and prevent hospital admissions.
Presentation at the Pharmacy Show Oct 2015: The Carer-friendly Pharmacy – Julie Ellis (If prompted, password is: pharmacy15)
The Centre for Pharmacy Postgraduate Education (CPPE) has carer-awareness learning resources on their Learning Pharmacy website, a free online learning environment which provides learning activities for the whole community pharmacy team. It has fun and interactive bite-sized learning challenges that can be accessed by everyone without the need to log in.
CPPE also has a number of other training programmes, on certain conditions and diseases, for example, dementia which may allow pharmacists and their teams to gain better background knowledge and give a higher level of support to carers. A list of programmes and assessments can be viewed on the CPPE Please note you will need to be registered with CPPE to access these.
The Carers UK website offers a ‘Carer Awareness: supporting frontline practice’ e-learning course, which covers topics such as how to identify carers; defining what it is to be a carer; and the impact of caring and how to identify when carers need more support.
The NHS website also has lots of information on caring for carers, which may be another useful resource to signpost carers to.
A practical guide to healthy caring – Pharmacy teams can order free copies of the guide to provide to carers by phoning Prolog on 0300 123 1002, quoting reference HC1 or online at www.orderline.dh.gov.uk.