The health and wellbeing of carers has increasingly been the focus of healthcare providers in recent years. The Carers Strategy: Second National Action Plan 2014-2016 identifies complex challenges for carers in England, including poorer health outcomes. It emphasises the importance of high-quality, person-centred care by GPs for a group of people whose own health deteriorates incrementally with increased hours of caring.
The GP Patient Survey (GPPS) gives us insight into the experiences of people who care or provide support for someone due to physical or mental disability or ill health, in relation to general practice. Around a fifth (18%) of participants in the survey say that they care for someone or provide support to somebody due to physical or mental ill health. By examining the GPPS data we can see how caring responsibilities impact experience of GP services.
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Overall experience of general practice does not appear to be affected by caring responsibilities, but this does vary between carers of different ages:
- Carers and non-carers report a similarly positive overall experience of their GP surgery, with 85% of both groups saying that they have a good (very or fairly good) overall experience of their surgery.
- However, carers are more likely to have visited their surgery in the past 12 months than non-carers; 86% having seen a GP compared with 83% of non-carers.
- In spite of visiting their GP surgery more regularly, views of making an appointment are similar for carers and non-carers. Similar proportions report being able to get an appointment (88% versus 89% respectively), and say that it was convenient (92% versus 92%).
- However, this experience varies by age; while young adults overall are less positive about their experience of making an appointment, the experience is even less positive for young adult carers (61% of 18-24s compared with 83% of 65+ have a good experience of making an appointment).
Carers have a greater need for personalised care, and are more likely to say they have a preferred GP:
- While around half (48%) of non-carers have a GP that they prefer to see, more of those caring for 1-9 hours a week have a preferred GP (55%), increasing to 64% of those with the greatest caring responsibilities (50+ hours a week).
- In spite of this greater preference for seeing a particular GP, carers are slightly less likely to be able to see that preferred GP always, almost always or a lot of the time – 57%, compared with 59% of non-carers. That said, carers and non-carers have the same levels of confidence and trust in the last GP or nurse they saw (both 95% for their GP, and both 97% for their nurse).
Carers tend to be heavier users of out-of-hours services:
- Carers are more likely to have used out-of-hours services in the past six months, especially for someone else (13% compared with 7% of non-carers). Although carers have an increased need to use out-of-hours services, they report lower levels of satisfaction; not only are they more likely to feel that it took too long to receive care and advice (35% compared with 31% non-carers), but they also report a poorer overall experience (17% compared with 15% non-carers saying very or fairly poor).
There are some notable differences in the age and gender profile of carers and non-carers:
- Carers are more likely to be female; 56%, in comparison with 49% of non-carers.
- Carers tend to be older with around half (48%) aged 45-64 (compared with 31% of non-carers).
- The level of caring responsibility increases with age: those aged 65+ spend longer providing support than young adult carers aged 18 to 24 years (31% and 11% respectively provide 50+ hours of help per week).
Carers are less likely to be in full-time or part-time paid work than non-carers:
- Around half of carers (56%) compared with 61% of non-carers work full-time or part-time. This difference is directly related to increasing caring responsibilities, and the proportion of those caring for 50+ hours per week who work decreases to 30% (partly related to age, although those caring for 50+ hours per week are also more likely to be retired than other groups).
- Carers are also more likely to be working part-time than non-carers; 17% compared with 13% of non-carers.
- Carers who do work are less likely to be able to take time away from their job to see their GP compared with their non-caring peers, and again this becomes more pronounced with increased hours spent caring.
Carers are more likely to have a long term health condition than non-carers:
- Three in five carers say that they have a long term health condition (61% compared with 52% of non-carers).
- Although this is related to age, with the older age profile of carers meaning that they are more likely as a whole to report having a long term health condition, this is not the whole story. Not only are carers overall more likely to have a long term health condition, this pattern is more pronounced among young adult carers. Significantly more young adult carers (aged 18-24) report a long term health condition than their non-caring peers (40% compared with 29% respectively). For those aged 65+, however, the proportion reporting a long term health condition is the same (83% compared with 84%).
Carers report poorer health outcomes across a range of measures, in terms of pain/discomfort, mobility, difficulties with self-care and daily activities, as well as anxiety and depression.
- Again, the disparity between the overall wellbeing of carers compared with non-carers is more pronounced for young adults. For example, 45% of carers aged 18-24 suffer anxiety and depression, compared with 31% of non-carers of the same age. Amongst those aged 65+, the difference is just 3%.
Ipsos MORI administers GPPS on behalf of NHS England. The survey consists of around 2.2 million postal questionnaires being sent out each year. The current overall response rate to the survey is 38.9% based on 836,312 surveys returned between 2 July and 2 October 2015, and 4 January and 1 April 2016. Data are weighted to match the profile of the population. Read further technical information about how the survey works. For more information about the survey, and access to the data see www.gp-patient.co.uk.