GP Audits and Investors in Carers Standard Accreditation Northamptonshire Carers Louise Shaw Primary Care Interface Lead & CASW Hazel Wright Adult Services Manager 5 th November 2014 Carers Trust Learning Event
Introductions Hazel Wright Adult Carers & Primary Care Service Manager Louise Shaw Primary Care Interface Lead & Carer Assessment Support Worker Northamptonshire Carers An independent local charity in our 20 th year. Partner of Carers Trust national network of Carers Centres Working in partnership with health CCG s and local NHS Foundation Trust, social care, schools and other voluntary sector stakeholders Offer a countrywide service supporting Young and Adult Carers Wide range of services including provision of Carers Assessments 2
Northamptonshire Carers Services Northamptonshire Carers Support Line 01933 677907 central point of contact information/advice/ emotional support Mon-Fri 9:30am 4pm Carers Assessment & Support Free gym sessions Carers Sitting Service Free holiday chalets in Saxmondham in Suffolk Carers Choir Take a Break Trips Carers Lunch Break Reiki and Relaxation Regular Telephone Support 1:1 Peer Support Support Groups (19 across the County including Carers Café drop in) 3 Other Essential Services Needs & Aspirations free training & leisure activities funded by County Council Crossroads Emergency Care Service free care for up to 72 hrs, 3 x per yr max funded by County Council for emergencies or planned events
Man Power Behind Our Services Board of Trustees Director (f/t) Senior Managers x 5 (4 x p/t,1 x f/t) Team Leaders x 2 (ft) YC Team Lead (ft) NHS HFT funded CDSW s x 12 started 2005 now x 5 (4 x f/t, 1 x p/t) County Council funded CASW s X8 started 2009 now x 3 (2 x f/t, 1 x p/t) CCG funded CASW s X7 started 2010 now x 5 (3 x f/t, 2 x p/t) Young Carers Team started 1995 now x 5 (3 x f/t, 2 x p/t) Other Project Co-ordinators/Support Workers x 7 (2 x f/t, 5 x p/t) Admin x 4 (2 x f/t, 2 x p/t) Volunteers x 60 approx. Northamptonshire Carers employs 38 staff including 13 CASW s (+ 1 FTE to be recruited) 4
Primary Care Interface Work Our Journey Project now in its 5 th year: Focus - to help practices recognise pivotal role in early identification of Carers and in safeguarding Carers mental and physical wellbeing. Year 1 (first 18mths) Sep 09 Mar 11 DOH funded pilot 2010 team of 7 CASW s employed by PCT set up recruited 23 volunteer practices. Encouraged identification & referral to NC Who Looks After You website and campaign was also commissioned. Year 2 Apr 11 Mar 12 PCT funded became countywide covering all surgeries (102 surgeries 85 practices) publicity material further developed - video to encourage future CCG funding Year 3 Apr 12 Mar 13 - CCG funded for 3 yrs, now extended to Mar 16. Team restructured. Began working in acute hospitals - Northampton & Kettering let Primary Care work coast - referrals dropped by 50% 5
Year 4 13 14 Registration & Referral League Tables April 13 reports to all surgeries showing Carer referral over 3 yrs since pilot began. Aim stimulate competition and enable surgeries to judge their performance able to see consistency of referrals year on year able to compare their referral rates against other practices able to see drop in referral 12-13 publish referral table every 6 mths now publish registration table annually 6 Alongside ref report advised of introduction of Annual Audit
Year 4 13 14 Carers Annual Audit Annual Audit Introduced Aug 13 to Examine and improve existing Carer support and increase: 1. Identification and Registration 2. Referral for support 3. Monitoring of health/wellbeing to prevent escalation of Carers & Cared Cares and Cared For s needs rejuvenate staff awareness of Carers issues and services available offer CASW support and materials to implement/improve systems surgeries committed to Action Plans and audit review meetings more successful than we imagined with 51/76 (67%) of practices inviting us in to complete the audit led to 35 carer awareness training sessions being delivered to clinical and/or nonclinical staff and Patient Participation Groups 7
Carers Annual Audit Audit Action Plan Example Audit scoring system created Action Plans - key element to audits Follow up and review required Important to provide ready made solutions - electronic templates Agreed Action The NPR form is in the process of review/update. DT agreed to change the wording to 'Do you look after someone?', 'Does someone look after you'. DT is committed to improving the process for registration/coding and is likely to adopt the Carers Policy template which LS provided. LS to provide electronic copy of Policy. LS provided copy of Carer Registration and Opt Out Referral form which DT will consider adopting. LS to provide electronic version. DT is committed to ensuring referral process is firmed up and that staff are all aware of it. By (initials & date) DT 01/10/14 LS 04/04/14 DT 01/10/14 LS 04/04/14 DT 01/10/14 GP Identification Tool Kit created but no longer giving everything only the docs relevant to action plan (currently under review) DT to consider providing information sharing agreement between patient and Carer which can be given to Carers or Cared For on identification. LS provided hard copy of a Info Sharing Agrmt and will send electronic copy. As part of the Carer identification, registration and referral process DT will check flagging system and ensure Carers visible to all staff and the importance of correct flagging procedures is known. LS 04/04/14 DT 01/10/14 DT 01/10/14 8
Year 5 14-15 Investors in Carers GP Standard Accreditation 9 4 levels of attainment: 1. Bronze 2. Silver 3. Gold 4. Gold Plus Scheme aims: Improve identification of and support available to Carers Acknowledge work undertaken to support Carers by Northamptonshire GP teams Provide an accredited framework for GP teams within which to develop services and good practice Modelled on schemes in Ceredigion & Wiltshire. Hoped it may become part of a nationally recognised Investors in Carers Standard. Accreditation panel constituted (inc Carers, CASW s, GP, CCG & County Council) Surgeries can submit evidence to the panel in April and October each year Accreditation valid for two years, after which further evidence required to maintain award.
Investors in Carers GP Standard Levels Gold Plus (the sparkler) Creative initiatives. Sustained engagement. 5% min of PP to be registered as Carers 75% of the 5% referred to NC for support Gold (the cherry) Health checks & specific support initiatives. 4% min of PP to be registered as Carers 60% of the 4% referred to NC for support Silver (the icing) More proactive activity by surgery. 2% min of PP to be registered as Carers 30% of the 2% referred to NC for support 10 Bronze (the cake) Most important level ensures identification, reg and ref systems in place. 1% min of PP to be registered as Carers 15% of the 1% referred to NC for support
Investors in Carers GP Accreditation (first applications April 14) In first round 6 submitted applications All surgeries achieved standard applied for (5 x Bronze, 1 x Bronze & Silver) All expressed intentions to work towards the higher levels. Many surgeries intend to apply for accreditation in the next round of applications at end Oct 14. Scheme put forward as example of good practice at NHS England and RCGP Carers summit July 14 11 Carers Wellbeing & awards event 1 st Oct attended by around 100 professionals and Carers including the Chair and CEO of local NHS Foundation Trust, Chair of Nene CCG, Cabinet Member for Health & Wellbeing, Director of Adult Social Services
Investors in Carers GP Accreditation Gives surgeries something to aim at Provides framework for team discussion Clearly defines areas for development and improvement Allows them to see what best practice should look like Email received 31/10/14 from surgery who achieved Bronze in first round: 12 Hi Louise, we won t be submitting for the Silver Award for Carers because although we are well over 2% of carers identified we have not referred 30% of these to yourselves only 20%. We are going to look again at how we approach referrals with our carers, since we offer to refer but seem to be getting carers saying they will take away the pack and think about it, rather than accept a referral now. Also a couple of our clinicians may be saying to patients to self-refer, rather than doing it there and then. Hopefully you will run the award scheme next year too and by then we ll have got this referral process sorted again.
Outcomes creating a BUZZ! 51/76 (67%) of Practices completed the 2013 Carers Audit Unprecedented interest by funders and stakeholders Most surgeries have improved systems and Carer signposting Since audit and IiC introduced referrals have more than doubled 6 surgeries applied for IiC accreditation with 5 achieving Bronze and 1 achieving Silver at least 4 more applications in Oct = 10 min led to piece of work with CCG looking at SystmOne & Emis Carer Template to include Health Checks - essential for robust more automated identification, registration, referral and continued monitoring of Carers health 96% of all Practices have made referrals since 2010 13
Outcomes improved Carer support. By Mar 15 around 2,000 Carers should have received support and access to services as a result of referral by Primary Care since 2010. These Carers have reported improvements in their health and wellbeing and a reduction in use of GP and hospital services. 45% less likely to access hospital services for themselves or cared for 86% reported an improvement in physical health 77% feeling less stressed 82% felt more confident to carry on caring 50% felt treated with more respect by professionals & expert partner in care 76% reported an improvement in their quality of life From Outcomes Monitoring Survey of 500 long terms Carers who received NC service 13-14 14
Over to you Points for discussion: 1. Have you / would you introduce Audit and / or Investors in Carers GP Standard in your area? 2. What would you / have you done differently? 3. Do you think the Standard would benefit from being a nationally accredited? 4. Who do you think are best placed to head a national Investors in Carers GP accreditation scheme 15
Any further questions? Contacts: Louise Shaw Primary Care Interface Lead & CASW 07785 335809 louises@northamptonshire-carers.org Hazel Wright Adult Services Manager 07984 933480 hazelw@northamptonshire-carers.org Tel: Email: Northamptonshire Carers 123 Midland Road, Wellingborough, Northants, NN8 1LU 01933 677837 (Mon Fri 9:30am 4pm) carers@northamptonshire-carers.org Twitter: @NorthantsCarers 16