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9 February 2021

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This article has been provided and sponsored by Quality Compliance Systems.

Author: Alison Lowerson, QCS, GP Policy Lead

QCS’s Alison Lowerson reveals the issues that every GP surgery should consider when it comes to carers and the compliance steps that can be taken to support them.

Although it is becoming sadly familiar, when the UK government announced a third national lockdown, the depression and deflation that people had felt in the first two lockdowns gave way to a feeling of exhaustion.

But spare a thought for the nation’s seven million carers. The last 10 months have been extremely challenging for them. Not only have they continued to provide continuous support to loved ones throughout the crisis, but have done so with limited help from the state.

The government needs to do much more to help them. Not just because it is the right thing to do, but the millions of unpaid carers save the state billions of pounds in social care costs.

According to Carers UK, for every day of the pandemic that has gone by, unpaid carers have saved the UK £530 million Astonishingly, this equates to a saving of £135 billion so far.

Increased responsibility

But carers have received little reward from the government. Many carers have taken on more responsibility for their loved ones since the start of the pandemic and, with rapidly declining support due to the restrictions, they feel isolated, overwhelmed and are struggling to maintain the care that their loved ones’ need. Indeed, many carers have also chosen to shield to reduce the risk of passing on the virus. However, often this makes it hard for them to access food, financial support, medicines and medical help.

Identifying and supporting carers

What can GPs do to help? And how can compliance best inform them? On a practical note, practices can add value by better identifying those who are carers to give them the best chance of getting the support that they need. Simply asking ‘Do you look after someone?’ can be a more effective question than ‘Are you a carer?’

But it barely scratches the surface. Practice managers need best practice guidance. Firstly, I would recommend that practice managers look at the advice laid out by NHS England and NHS Improvement. It has recognised the challenges that GPs face in this area and it has produced a Framework of Quality Markers for supporting carers in general practice.

Meeting regulatory standards

In addition to best practice, practice managers also need to be aware of how regulation affects the practice. What constitutes outstanding practice in this area? How do Practices create practical policies and procedures that are aligned to CQC guidelines?

As the GP Policy Lead at Quality Compliance Systems, our team specialises in creating industry leading compliance. It’s our job to keep abreast of all the latest developments in guidance, standards and compliance. We then use that knowledge to produce leading-edge content and best practice, which we break down into easily digestible policies and procedures.


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So what does the CQC expect? When the CQC carries out an inspection, it will look at how effectively carers are supported when they consider the following key lines of enquiry:

C2: involving people in decisions about their care

R1: how do people receive personalised care that is responsive to their needs?

For practice managers, when making changes in the practice, or preparing for an inspection, the NHS Framework of Quality Markers document is a great place to start. The guide offers a series of practical ideas for improving how general practice can better identify and support carers of all ages. There are six quality markers and they are as follows:

  1. How the practice identifies and registers carers
  2. How the practice uses its carer’s register to support holistic carer health and wellbeing needs
  3. How the practice organises itself to understand and respond to the needs of carers
  4. How the practice makes it easier for carers to access its services
  5. How the practice communicates with, involves and informs its carers
  6. How the practice promotes a carer-friendly culture

Not only does the framework lay solid foundations in a practice, the CQC is likely to base its questions on the document during a face-to-face inspection or a telephone discussion.

Additional resources are available to support carers

Secondly, the NHS Carers toolkit also helps organisations to work together in identifying, assessing and supporting the wellbeing of carers and their families. It covers duties of NHS organisations brought about by the Care Act 2014 and the Children and Families Act 2014 too. It also includes numerous examples of positive practice that are already making a difference to carers and their families.

The Network Contract DES Additional Roles Reimbursement Scheme has been expanded to include health and wellbeing coaches, who will be expected to support patients and their carers – ensuring their changing needs are properly addressed.

Supporting the wellbeing of carers in the workplace

The toolkit emphasises the importance of emotional wellbeing. According to Carers UK, ‘five million people juggle work and care in the UK’. That amounts to ‘one in seven of the workforce’.

Caring for someone, even when we are not in the midst of a pandemic, can be both physically and emotionally demanding and puts pressure on employees to balance their work and other responsibilities. Sadly, it is a balance that many don’t achieve. Carers UK says, for example, that one in six carers end up giving up work or reduce their hours to look after their loved ones.

Practice managers can help in this respect. They should monitor the wellbeing of staff. By simply asking employees if they are carers, they can find out the difficulties they may be facing. Practice managers can then offer support, including providing the opportunity of home working or flexible working if possible. This not only demonstrates they are a responsible employer, but it can also have a positive effect in the workplace and on the delivery of patient care.

This is where QCS policies can make a difference. In addition to the Home Working and the Flexible Working Policies and Procedures, QCS has produced an Employee Welfare Checklist, which covers staff issues and concerns as well as identifying any support they may need.

Practical steps to support carers

Working closely with carers, who are patients or staff, can promote a greater understanding of the challenges they face and providing much needed support can enhance working relationships. Practices should be raising awareness of caring and caring issues by supporting line managers and providing staff training, as well as reviewing policies such as the QCS Carers Policy and Procedure. Carers should be identified, especially in the workplace, and offered opportunities to manage their caring responsibilities, and they should be signposted to external support.

Additional resources

  • Carers Policy and Procedure
  • Home Working Policy and Procedure
  • Flexible Working Policy and Procedure
  • Employee Welfare Checklist

To find out more about QCS, contact our compliance advisors on 0333 405 3333 or email [email protected].