Working with practices Supporting carers

1. Working with practicesSupporting carers Matthew Byrne Head of Carers Services, Westbank, Devon

2. What will I talk about? “Working in partnership with urban and rural practices to identify and support carers and to deliver health and wellbeing checks.” • A bit about Devon and Devon Carers • Clinics and drop-ins • Health and Wellbeing Checks (HWBCs) • Simple lessons from our practice • Does it make a difference?

3. Devon and Devon Carers • Large rural county – 82,000 carers • Pockets of urban and rural poverty • Devon Carers • provides information, support and short breaks • works with carers of all ages across Devon • includes targeted services around • engagement and involvement • hospital discharge • young adult carers • and works with ~100 rural/urban practices

4. Clinics and drop-ins • We offer each one a monthly clinic/ drop-in staffed by a CSW (each does between one and six per month). • We currently run clinics/drop-ins in more than 75 of the 100 practices. • The approach taken varies from practice to practice. • The lead in time can be six months plus.

5. Clinics and drop-ins • Practices vary in what they prefer: • Some urban practices share premises and work together to offer fortnightly clinics. • Some rural practices have multiple sites and the clinics move around each month. • Some just have a monthly clinic on their main site. • Hosting and administration (generally) the responsibility of the practice: • Some are open access with no need to book. • Others work on an appointment basis.

6. Health and Wellbeing Checks (HWBCs) • The HWBC is a holistic review of key areas of health and wellbeing: • Wellbeing aspects are guided by the use of a booklet (generally completed in advance). • Health aspects are based on an NHS vascular check for those who meet the criteria. • The Health and Wellbeing (outcomes) wheel provides a measure of change/improvement. • Most HWBCs count as a Carers Assessment.

7. Health and Wellbeing Checks (HWBCs) • A LES currently funds 50+ practices (and 20+ pharmacies) to offer HWBCs. • Devon Carers staff also offer HWBCs: • CSWs and peripatetic nurse(s). • Working directly with practices and in the community (eg. village halls). • At carers forums and other events (eg. libraries and workplaces).

8. Health and Wellbeing Checks (HWBCs) • Devon Carers led development of the HWBC and associated training/competence framework. • Devon Carers currently supports partner delivery: • Training for partner staff delivering checks. • Advice and mentoring (directly and funding peer mentors). • Help with carer identification, including ‘kick-start’ funding (eg. to tidy up carers registers). • Direct promotion, provision of publicity materials, and providing a clearing-point for enquiries. • A peripatetic nurse can deliver checks for partners(eg. to cover staff absence) – we re-charge for their time.

9. Lessons from practice • Clinics and drop-ins • open access approach • sometimes no-one comes (once 37 came) • use the time to talk to practice staff • appointment approach • more predictable – better use of resources? • best where practice ‘owns’ promotion and booking (some have our CSWs on their IT systems like their practice nurses)

10. Lessons from practice • Health and Wellbeing Checks (HWBCs) • requires greater practice commitment • “being good for carers” is rarely enough • evidence that it works • links to other targets and outcomes • a business case that pays for itself • know the system, speak the language • ensure the LMC (and LPC) are in the loop • if you have connections – use them (eg. ex-NHS staff) • don’t compete with NHS comms. – feature in them

11. Lessons from practice • Working with primary care – influence • some welcome us with open arms • some we are still pushing on the door • don’t assume – some really don’t know about carers • do your homework – website, population, challenges • they really are all different – be flexible • be persistent but not annoying • a champion – whether receptionist, HCA or GP – is key (identify the staff who are carers) • keep knocking, smiling, and being astounded

12. Lessons from practice • Working with primary care – final top tips • quick wins are there (point them out) • “carers pick up prescriptions for others” • practices do mailings and newsletters • it doesn’t take much to put a link on a website (or to make a simple referral slip for a GP to use) • regular reminders at practice meetings • practices have constraints, just like us • some have windy stairs and not enough rooms • space is limited; make posters small • so is time; put them up yourself

13. Does it work? • Much of our this work grew out of a successful DH Demonstrator Site programme: • The programme resulted in increased identification of carers in participating practices and this has continued. • Carers reported better health and wellbeing as a result. • We deliver services for carers in three quarters of our practices; we must be getting some of it right. • We are continually developing and improving, in partnership with primary care and led by carers: • Measurement of outcomes has been further developed and continues to show immediate and long-term benefits.

14. Thanks for listening! Matthew Byrne m.byrne@westbankfriends.org 08456 434 435 www.devoncarers.org.uk