Our Dorset Carers Collaboration – Standardising ‘unpaid carer’ coding in Dorset’s General Practices on SystmOne
On this page
- Lead Organisation
Dorset Healthcare University NHS Foundation Trust and NHS Dorset
- Project contact
Lizzie Eden – Carers Engagement Facilitator for Dorset GP Practices
- About ‘Our Dorset Collaboration’
The Our Dorset Carers Collaboration represents our partnership working across the ICS, and the joined up approach that underpins these projects. These projects were worked on jointly within the Dorset Carers Partnership Group (DCPG). The DCPG brings together key partners in health, social care and VCSE sectors working with carers across the Dorset-wide footprint. We come together to network, raise awareness of carer support, discuss areas of challenge, and work in collaboration for the benefit of carers on a range of projects in line with the Pan Dorset Carers Strategy priorities.
The project was initiated to standardise how unpaid carers are identified within patient record systems in Dorset primary care services (all Dorset GP Practices use SystmOne). SystmOne uses various codes for categorising people: there are over 20 different codes relating to “carer” an unpaid carers were being coded using numerous different codes across Dorset. As a result, it was difficult to report meaningful statistics for unpaid carers in primary care services. Accurate and consistent coding on patient records supports reporting, patient care and adapting services to meet population needs.
The issue of ineffective coding is also a national concern, and since this project commenced in 2018, NHS England has produced national guidance (NHS England Coding unpaid carers 2022). This encourages primary care services to use a small number of codes in order to identify people with caring responsibilities.
Working closely with IT colleagues, a SystmOne ‘Dorset Unpaid Carers Template’ was developed which, once populated and saved, automatically adds the correct carer code to a person’s profile. Creating a local template in conjunction with carers and Dorset GP Carers Leads, it evolved to include sections concerning a carer’s health and wellbeing, such as whether they have had their flu vaccination; any mental health concerns and a function for signposting to further support
We now have a mechanism to work towards more reliable primary care data for unpaid carers. We have seen increased use of the selected codes used within the “Dorset Unpaid Carers template”; its use has been promoted across Dorset’s GP practices.
- Partners
Primary care colleagues across Dorset, NHS Dorset ICB (previously Dorset CCG), Dorset Healthcare colleagues, Dorset Insights and Intelligence System (DiiS) BI tool, Carers with lived experience, Dorset Council, Carer Support Dorset (CSD), Carers Resource, Information and Support Programme (CRISP)
- Project duration
2018 – ongoing
- Key beneficiaries
Carers, staff working with carers, carers leads in primary care networks.
Our Dorset Carers Collaboration – Standardising ‘unpaid carer’ coding in Dorset’s General Practices on SystmOne
Why we started this initiative
GP practices in Dorset coded unpaid carers using various different carer codes; there was inconsistency between practices and even between individual staff members within a practice. It was impossible to extract an accurate data set of people with caring responsibilities, thus hindering wider work and strategic planning.
Another large motivation was to clarify for practice staff how to better support their unpaid carers. The template would offer confidence and a clear guide on what a discussion with a carer might look like, how to code them effectively, and what other support to signpost to.
Our goals
• Standardise how unpaid carers are coded across primary care
• Create an simple tool for all staff to implement
• Improve accuracy of coding and help keep information more up to date
• Offer better support for carers
• Improve our data to help us make better decisions about service development and planning
• Support the Carers Engagement Facilitator role to effectively target practices which may need further support and engagement to adapt
How we’re implementing it
The template was developed by Carers Engagement Facilitators and IT colleagues
• There was wide and consistent promotion through our internal and external communications channels
• We had regulate contact with Carers Leads
• Carers Engagement Facilitators promoted use of template in all engagement opportunities
• We worked with external organisations to make the most of existing expertise and technologies, eg BRIDGIT, an online information and support tool for carers
• There is clear, online information on the staff intranet as well as a printable guide
• Planning is essential. Think in advance about a communications plan, a timeline for your project and be specific around its scope.
• If you are not an expert in an area, find someone who is and shares the same goals. For example this work could not have been achieve without the SystmOne specialist and their willingness to get heavily involved in the project. This can be achieved through buy in at the more senior levels.
• Make sure promotion is clear, timely and consistent. Encouraging change within primary care settings takes time and reiteration. It is a service with many competing demands and priorities, and often a high rate of staff changes. Therefore, it is important to engage with these services in a way that is supportive and brings them along the journey with you.
• Think about how you will gather your ‘evidence of impact’. We can see changes in the coding data that without our role and our regular contact with GPs and carers leads, we could not be confident is due to the use of the template.
A region without a Carers Engagement Facilitator type role would need to be mindful of this if they were to develop their own local carers template.
Further information about the template
The sections of the template (linked below) are as follows:
• A tick box to confirm you want to code the patient using ‘patient themselves providing care’
• A tick box which removes the carer code if carer is no longer caring
• ‘Child codes’ (codes sitting underneath overarching ‘parent code’) are listed and able to be ticked to give detail about the type of care being provided or needs of cared-for person
• Open text box for general wellbeing
• Open text box for concerns
• Tick box to show advice given re flu vaccination
• Observations page – to be completed by appropriately trained staff
• Medications page – to be completed by appropriately trained staff
• Signposting page – if carer consents, template can auto populate and generate a letter template that can be sent to the appropriate local carer support service.