Improving Identification of Informal Carers in Tower Hamlets
Authors: Emma Robinson (Deputy Lead Nurse and End of Life Lead) and Clarissa Sørlie (Improvement Advisor)
Our Trust strategy at ELFT emphasises the importance of recognising and supporting informal carers and including them in discussions about patient care. According to Carers UK, one in seven people in the workplace are juggling work and caring responsibilities, which rises to one in three in the NHS (Carers UK, 2024). However, when Emma Robinson (Deputy Lead Nurse) reviewed the data in early 2023, an average of nine carers were identified on clinical records (EMIS) across Tower Hamlets Community Health Services (CHS). Without clear identification of carers, clinical teams cannot offer support or involve them in patient care. The impact of this was evident in feedback from carers: they were exhausted and stressed and were not receiving enough information or being included in care planning.
Determined to improve identification and support for informal carers, Emma called together a project team. It was essential for the team to have an informal carer in the project meetings, to keep the team connected to why they were doing the work.
Using a tool called a driver diagram (see Figure 1 below), the team identified key factors they wanted to address to achieve their aim of increasing the number of carers identified on EMIS from 9 to 70 by August 2024.
Figure 1. driver diagram outlining the team’s theory of change
In September 2023, the team launched an EMIS template working group across Tower Hamlets and Newham to accelerate testing and learning. The new template encourages staff to consider informal caring arrangements, and to include carers in care planning discussions. There is also a prompt to initiate a discussion about carers’ support needs. Reflecting on this work, Emma said, “We’ve never been able to change anything on EMIS before. It took a number of months, but being able to make changes that benefit carers in both Tower Hamlets and Newham was worth it.”
From November, Fathama Rahman, a Carers Hospital Support Worker from the Tower Hamlets Carers Centre started spending one day per month on-site within the service. Not only does this serve as a reminder for staff to consider carers in their work, it also makes it easy for staff to make a direct referral to the Carers Centre or seek further information. Fathama said, “It truly has been heartwarming to see the eagerness of staff in Tower Hamlets CHS in wanting to support informal carers. I am excited about our partnership and look forward to this developing and growing and supporting more carers”.
As a result of their efforts, the team have seen an increase in carers identified from an average of 9 to 48 – a 433% increase.
Figure 2. Control chart showing improvement in number of carers identified
Emma has also reviewed EMIS documentation to understand the quality of support offered to carers. “Reviewing the documentation and seeing all the support that carers are being offered is very moving”, says Emma.
The team’s biggest lesson has been in how many informal carers didn’t recognise themselves as carers or the impact that their caring roles were having on their own health and wellbeing. Without this recognition, carers were not able to access the support they needed.
The team are now recruiting a team of volunteer carers to speak with other carers, seeking specific feedback to enable them to understand the experience carers have when they access CHS services, and what can be further improved.
References:
Carers UK (2024) ‘Key Facts and Figures About Caring’ [Online]. Available at: https://www.carersuk.org/policy-and-research/key-facts-and-figures/ (Accessed: 3rd June 2024)
