The Carer Friendly Employer

At any one time roughly ten per cent of the population is an unpaid carer. Although becoming a carer can be hugely rewarding, it often comes about unexpectedly and can have a huge impact on peoples' lives - both personally and professionally. Whilst the RCGP encourages its members to support carers in their area through a range of resources, we are also encouraging practice teams to think about the ten per cent of practice staff who have their life turned upside down by their sudden caring role. 

Below is a true story (with changed names) about how a practice in the south of England developed into a carer friendly employer.

'In 1983, the mother of the junior partner not only developed breast cancer, but her cor pulmonale took a dramatic turn for the worse following radiotherapy. It became obvious that she would need constant nursing and care. Dr Anafield was pregnant and had been very nauseated, but she still had a considerable amount of annual leave to take. Although she and her husband were between houses and living with her parents, she and her sisters decided to share her mother's care, with Dr Anafield doing Friday through to Monday with her father. A short chat with the senior partner resolved her anxiety - and the other partners were more than sympathetic, realising that it was better to have her working three days each week in the knowledge that she would work hard in that time rather than her taking a lot of time off. Sadly Dr Anafield's mother died in the second week of this arrangement, but a precedent had been set.

Over the years more of the staff took on a caring role, most usually for their aging parents, as well as holding down their jobs. It was ten years ago when the concept of carers became more of a recognised entity and the partners also became more aware of the need to be not only carer-friendly but also carer aware. All those years ago, the senior partner had misquoted a Latin refrain - quis custodet (ipsos) custodientes. He felt that it could also be translated as 'who care for the carers' and this concept has remained the maxim for the partnership. It seemed a very apt way to describe a practice that had developed an ethos of caring for one another.

In the past couple of years being carer-friendly has really been put to the test for Dr Anafield and her colleagues. It started when the husband of Nurse Alison had an MI while they were on holiday abroad. Her fortnight's holiday burgeoned into three months - the whole team rallied round, not only in terms of work but also keeping in contact and liaising with her daughter, sorting out her mail and the cat, and getting spouses and partners to cut the grass and keep the weeds under control. Alison is still working, albeit more part-time than before.

Marjorie and her daughter Clare are receptionists. When Clare's baby was born feeding was difficult and even after surgery there were numerous hospital appointments. At about that time Marjorie's parents also began to have health problems and so she became a sandwich carer. Not unexpectedly she also managed to hurt her back through a combination of transferring her parents from bed to chair/commode and carrying the baby. The baby is better, however Marjorie still provides childcare as well as looking after her parents.

One of the nurses, Ben, is a good example of a young adult carer. He quietly ensures that his younger siblings get to school on time each day and then slips home at lunchtime to check on him mum. He is invariably a few minutes late in the morning, but is always helpful and friendly. Lucy, another nurse, has recently become a carer for her mother. Her clinics have been modified around hospital visits and the rest of the nursing team have managed to absorb her workload when emergencies have occurred.

The mother of Dr Brightley Fell about four months ago. She was in hospital for several weeks, had numerous investigations, developed C diff from the exotic antibiotics and was eventually discharged home - late on a Friday afternoon with an inadequate care package. By other partners doing one of her afternoon surgeries at short notice, Dr Brightley was able to be at the hospital at the same time as the Consultant. Thankfully her mother is now home, has a paid live-in carer who is marvellous and support also from her GP, who visits regularly. Dr Brightley is still a carer, but a much less stressed one!

At times it feels as if everyone has dipped in and out of the caring role. Perhaps working in General Practice attracts those more likely to take on the demanding role of being a carer. The above partnership has taken the view that flexibility is important and as long as the day job gets done without overworking the rest of the team for too long then it is fulfilling its commitment to be a caring profession. How long can this flexibility be sustained? There is no simple answer - probably longer than the cares. What is remarkable is that all these people are cheerful, efficient at their jobs and grateful for the flexibility that they have been afforded.

There are some changes being made in Employment Law which took effect from 30 June 2014. The right to request flexible working is extended to all employees with 26 weeks service. ACAS are producing a new Code of Practice and non-statutory guidelines for employers. More information on this legislation can be found at the ACAS website or the website.

The RCGP encourages practices and members to consider the demands on the carers within their teams and help to make flexible working for them an option. As you have seen above, simple changes and flexibility can go a long way. Visit the Employers for Carers website for more information, and make your practice more carer friendly for staff.

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