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Fact sheet

Setting up in-surgery appointments for GP Liaison workers

How is the initiative run?
A Carers Support Worker has agreed monthly two-hour appointments with surgeries, where they have a private space within the practice to speak to carers. These carers can be referred by the Practice GPs, nurses and staff, or they can self-refer. These two-hour sessions are advertised within the practice throughout the month, and the level of publicity increases on the day of the session. The session is advertised in Practice newsletters, on their website, on display boards, and on electronic media in the Practice.

In some practices, it has been agreed that a Practice Nurse is available to provide immediate medical appointments with carers when urgent need is identified through discussion with the Carer Support Worker.

In the private space the Carer Support Worker is able to discuss the carers’ needs, and how Carers First, other local support services, and the GP Practice can support them. The carer is encouraged to complete a referral form for the GP Practice, which will identify them as a carer, and to organise a health check with the practice – this can often be completed by the Practice Nurse on the day.

If the carer is unable to attend an appointment with the Carer Support Worker during the allotted two-hours, home appointments can be arranged – either directly through the Support Worker, or by leaving details with Practice Staff and requesting a call-back. The Carer Support Worker will always leave a space available for home visits the day after the in-surgery session, to help maintain momentum.

Information about the engagement with the carer, and what support they have been offered, will be written up and handed to the practice to include with the carers notes. Finding out how best to provide this information so that it can be added straight to the carer’s notes has been important, because it means that there is no extra work for the practice. It is of course important to understand what the carer is happy to share, and notes should be kept simple as GPs only have time for brief bits of information, and they just need to know that you are involved e.g. “referred to local Alzheimer’s Society for further support”, or “met with carer”.

What methods have been particularly effective?
Two things have really made this initiative successful:
“Keep comments short and sharp – GPs do not want to get involved with lots of paperwork. Also, they want to know that you will do what you say you will do”

  • Working with local carers to get a good understanding of the local environment, raising the carers’ organisations profile and advertising its services
  • Gaining the trust of the Practice staff, by showing them that the process works. This has been achieved by setting realistic targets with the practice, providing them with feedback, praising all the practices’ successes, and demonstrating added value to the practice in a way that they can relate to
  • Making sure that carers are feeding back to GPs on how useful the initiative has been to them, for example helping them to access outside support
  • Being prepared to meet carers at coffee shops, or outside of their homes, if they cannot speak to you at the surgery
  • Being flexible, and remembering that all practices do things differently: ask what they need and work in partnership with them

Have there been any challenges along the way?
“I highlight the fact that any new service being implemented within an existing structure takes time to establish, and perseverance is key to developing good contacts within a surgery, combined with structured feedback”

Getting that first carer to register that took eight months was a challenge, and it took a lot of patience and determination to stay focussed on the initiative. However, the work has paid off as shown by the high number of referrals following this.
Getting the GP surgeries to recognise the benefit of the service, although this has become easier as it has been shown to be effective in other surgeries: it has all been about gathering momentum.

What hints and tips might help me get started?
*Having some support from the PCT, and later social services, made it easier to engage with GP Practices
*It is important to talk to all of the practice staff
*When you are in the Practices, look out for things like ‘protected learning time’ – there will be adverts displaying Practice closures due to training – and ask if you can be involved in delivering some training
*Encourage word-of-mouth through carers to advertise the service that you are providing
*Maintain relationships with the practices, especially feeding back to the GPs – it is important that they know that they can trust you to do what you say you will do: if they refer a carer to you and then you refer them to social services, make sure that you pass-on information explaining this to the Practice to be added to the carers’ notes

Where can I get further information?
Lindsay Loft,
Carers First (Tonbridge) and Medway,
Riverside Business Centre
River Lawn Road
Tel: 01732 357 555
Fax: 01732 357 559

When was this information collected?
March, 2012

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