How can I coordinate my parent’s care?
As our parents get older their health issues can become complex. At one level hospital consultants are experts in their field but can be focused on the one issue without reference to anything else your parent is being treated for. At the local level your parent may be seeing a variety of GPs at the surgery and possibly a stream of district nurses at home.
So is there anyone who is actually taking a holistic view of your parent’s health and coordinating their care?
Who is responsible for my parent’s care?
In November 2013 the NHS agreed a change to GP contracts to ensure that patients over 75 get a dedicated GP personally accountable for their care. This change is due to take effect this year with the implementation of personal care plans integrating all services so your parent is better cared for in the community.
Whether your parent is seen solely by their GP or whether they have consultants, district nurses and community care workers involved in their treatment plan, their GP will be responsible for coordinating the care they’re receiving from these services.
GPs will be expected to:
- offer patients same-day telephone consultations
- provide paramedics, A&E doctors and care homes with a dedicated telephone line for treatment advice
- coordinate the care for elderly patients discharged from A&E
- regularly review emergency admissions from care homes to avoid unnecessary call-outs in future
- monitor and report on the quality of out-of-hours care.
What should we be asking my parent’s GP surgery?
If your parent’s practice hasn’t informed them of any changes it may be worth a call to the surgery to find out when the NHS reforms are being implemented in your parent’s area. That way you can establish which GP is going to be responsible for your parent.
Practices can now take on patients from other boroughs which means that your parent now has more freedom to choose where they’d like to be treated and by whom. The Family and Friends test is also being introduced into GP surgeries, offering patient views on whether their experience would encourage them to recommend that surgery.
Anything we should be asking my parent’s GP?
Whether your parent attends their doctors’ appointments alone or you accompany them it may be a good idea to make a list of all the health issues they want to discuss to make sure your parent gets the most out of their appointment.
With the NHS changes calling for transparency in doctor-patient relationships your parent should now receive letters from their various consultants and care providers explaining their prognoses as well as their proposed treatment plans.
This means you and your parent can now keep a track of what’s happening with your parent’s care using the letters as a form of reference should you become concerned that your parent’s treatment plan isn’t working for them.
Anyone with a long-term condition can ask for a care plan to help them manage that condition. The plan is for the patient rather than medical staff, but it’s worked out and agreed between them. The plan can include information such as:
- What your parent wants to achieve as their health improves, such as getting out of the house or starting a hobby
- Who is going to provide the support services that have been agreed and when they will be given Emergency numbers
- Eating and exercise plans
Hospitals will often provide care plans on discharge and they can be provided by GPs as well, and should be reviewed regularly.
How much does your GP know?
A trawl of your parent’s surgery website may well give you the favoured specialism of the various GPs. It’s quite unlikely though that geriatrics will feature anywhere near as strongly as antenatal care or other interests. As the population ages that will need to change.
The good news is that at least one organisation - The Association for Elderly Medicine Education (AEME) has been working to encourage junior doctors to specialise in geriatric medicine. A first conference on Geriatrics for Juniors in 2013 was supported by health groups, the British Geriatrics Society and AgeUK, and was attended by 140 junior doctors from around the UK. The conference explored the issues that are holding back junior doctors from moving into geriatric medicine.
How can a pharmacist help?
If it’s a review of their medication that’s needed then your parent’s local pharmacist can help. Your parent can have a private consultation and a Medicines Use Review to adjust prescriptions and – very usefully – identify medicines that might have been added to the repeat prescription list at some point but can now be safely removed.
Who can help us with care coordination?
If your parent can’t cope managing or remembering their appointment or medication regime it may be a good idea to hire them a personal assistant or carer who’s able to take them to appointments and manage the diary for them. These can be paid for from the new Personal Health Budgets being introduced this year which enable people to manage more of their own care.
Is there anything I can do?
- Talk about it. Make sure your parent feels involved in their care plan. If they’re not happy, find out why and how to make the necessary changes to ensure their treatment plan is maintained to a high standard and delivered by people your parent likes.
- Build a team. The people caring for your parent can have a huge impact on the quality of the care they receive especially if you parent doesn’t like them! Personalised care should be tailored to your parent’s personality, their wants and their needs. If you don’t live near your parent it might be possible to divide up the responsibilities between family members and keep the communication channels open.
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