Carers’ Information Service

The health of the person you look after is possibly one of the most important concerns for you. In addition to mainstream health provision, there are specialist services and teams for groups such as older people, children and adults with disabilities, people who have a terminal illness and those with mental health problems or drug and alcohol problems and we have given information about these here. For advice about health care in an urgent situation, see Help in a Hurry. Carers are more likely to have health problems themselves, directly as a result of caring for someone, so it is vital to access health services for your own needs too.

The Impact of Caring on Your Health

As a carer it is easy to neglect your own health needs because you are so focused on the well being of the person you care for. However, it is important that you look after yourself, both physically and mentally, and make sure your caring role is not having a negative impact on your health. If you stay as well as possible you will be more able to cope with the demands of being a carer, and this will benefit both you and the person you care for. Two of the most common health problems for carers are back injuries and stress-related illnesses. If you are helping someone move around, and have not been shown how to do so by a professional, you may be damaging your back. If the person you care for has a care manager ask them to help you find suitable training, or you could approach another professional involved in their care, such as a physiotherapist, for a demonstration of how to move someone safely. The Carers’ Information Service runs annual moving and handling training for carers; see Events for future training sessions. If you are already experiencing back problems, BackCare (0845 130 2704) offers advice and information on managing back pain. An effective way of dealing with stress is to talk about it; there are support groups and a counselling service specifically for carers in Croydon that you can access for free; see Information for details. There are also services that can ease the pressure by giving you a break from caring, see Short Breaks and Leisure.

Health Services

NHS Croydon (formerly known as Croydon Primary Care Trust) is responsible for ensuring Croydon residents get the healthcare services they need. This includes GPs, district nurses and other community health services, as well as hospital care.

Your GP will usually be the first professional you go to if you have any concerns about your health. Make sure you tell your GP you are a carer, and ask them to record the fact in your medical notes. This should ensure that you are offered the flu jab and a regular health check; your surgery may also have a carers support group. A GP who understands carers and is aware of your situation can be a gateway to other sources of support such as counselling, and can make referrals to agencies such as social services. You have the right to change your GP at any time and do not have to give a reason. Details of Croydon GPs, and also dentists, pharmacists and opticians, are available at www.nhs.uk or from the Primary Care Support Service on 020 8335 1400.

Carers can also get a free health check, which includes a blood pessure test; a body mass index calculation; advice about administering medication; a free prescription delivery service; advice about maintaining a healthy lifestyle, including support to give up smoking: and in-store discounts at Day Lewis Pharmacies in Norbury, Sanderstead and Thornton Heath.

Community health services in Croydon include:

The Children’s Hospital at Home Team (020 8714 2501) which provides acute nursing care for children who would otherwise be in hospital; nursing care; continuing care and play therapy for children with complex health needs; advice for families caring for a disabled child. Referral must be made via a health professional.
The Community Dental Service (020 8714 2708) which provides dental care for people who struggle to access mainstream dentists, such as people with a learning disability or people who are housebound. Self-referrals accepted.
The Continence Service (020 8714 2979) which provides advice, assessment and supplies of continence aids to people with bladder or bowel problems. Self-referrals accepted.
The Health Visiting Team for Older People (020 8714 2800) which provides information, advice and support on any health, social, housing or financial issue. The team usually works with people aged 55 or over. Self-referrals accepted.
The Occupational Therapy (OT) Service which provides support for people with physical disabilities to live as independently as possible. Adults can access OT via Croydon Social Services (020 8726 6500); the Children’s OT Service (020 8274 6850) can be contacted directly.
The Physiotherapy Service which provides advice, information and treatment for people experiencing a wide range of physical problems. Adults usually access physiotherapy via their GP; the Children’s Physiotherapy Service (020 8274 6850) can be contacted directly.
The Community Podiatry/Chiropody Service (020 8274 6820/6836) which provides footcare treatments for people who are at high risk of complications, such as people with diabetes. Referral must be made via a health professional.
The Speech and Language Therapy (SALT) Service which provides diagnosis and treatment of communication and swallowing difficulties. The departments for both adults (020 8401 3103) and children (020 8714 2594) can be contacted directly.

For information about Croydon’s community health services, please contact 020 8274 6300.

Hospital

While it is often the case that children and adults with a disability or medical condition will have hospital admissions, it is sometimes forgotten that carers sometimes have to go into hospital too. If you are concerned about who will look after the person you care for in your absence then you should contact their care manager, or social services if they do not have one; see Social Services about requesting a social services assessment. It is important to make social services aware of the situation as soon as possible, as you will need to request an assessment of the person you care for to see if they are eligible for community care services. It can take time for this process to be carried out and for alternative care to be arranged. You will need to work closely with the care manager in case of cancellation or postponement of your hospital admission. You may also need support in place once you are discharged as you may need time to recuperate and not be able to resume caring straight away. The care management team at the hospital should help arrange a package of care in this situation. If you have ongoing health issues that may result in sudden hospital admission, you may want to ask social services to help you draw up an emergency plan (perhaps as part of a carer’s assessment), so that if you are admitted to hospital unexpectedly you know the person you care for will be looked after appropriately and immediately.

If the person you care for is admitted to hospital you should be involved at all stages in discussions about their care. The person you care for should be assessed by the hospital care management team and a care plan drawn up which details the support which is to be in place before discharge. The care management teams at Croydon University Hospital can be contacted on 020 8401 3148 (Adult Care Management Team) or 020 8401 3409 (Children and Families Service). If, following assessment, the person you care for is deemed to have support needs that cannot be met by standard community health services, the Community Intermediate Care Service (CICS) may become involved. CICS (020 8714 2852) works to prevent hospital admission and encourages prompt discharge, and it can provide up to six weeks intensive support following discharge. You have the right to a carer’s assessment (see Social Services) to look at the support you will need if you have chosen to start, or continue caring, after a hospital admission.

If the person you care for will require a high, ongoing level of care that is directly related to their health needs they should be assessed for NHS continuing healthcare. If they are eligible for this the NHS will pay all health and social care costs for people living in their own homes, or all fees for those living in care homes. For more information on NHS continuing healthcare (or any aspect of Croydon University Hospital services), contact PALS at Croydon University Hospital (020 8401 3210). The Department of Health (DoH) publishes useful leaflets including NHS continuing healthcare and NHS-funded nursing care. Contact the publications orderline on 0300 123 1002 for copies.

Practical and befriending support for carers may be available during and after a hospital stay from the British Red Cross Hospital and Community Service (020 8401 3590) which is based at Mayday Hospital.

Mental Health Services

Mental health services in Croydon, for adults and children, are provided by South London and Maudsley (SLaM) NHS Foundation Trust (020 3228 6000, www.slam.nhs.uk). Mental health services, which can be accessed via referral from a healthcare professional include:

The Croydon Integrated Adult Mental Health Service which provides services for people aged 18-65 who have a severe mental health need.
The Croydon Integrated Mental Health of Older Adults Service which provides services for people over 65 who have a severe mental health need.
The Child and Adolescent Mental Health Service (CAMHS) which provides services for children and young people up to the age of 18.
The Primary Care Psychological Therapy Service which provides therapies for adults aged 18 and over with mild to moderate mental health needs.
The Croydon Integrated Psychological Therapies Service which provides therapies for adults aged 18-65 with moderate to severe mental health needs.

The majority of in-patient care for Croydon residents who are experiencing a mental health crisis occurs at Bethlem Royal Hospital, but there are two community-based residential treatment centres which can provide alternatives to hospital: Ashburton Road Crisis Unit and the Women’s Service. The Home Treatment Team works with adults aged 18-65 who are experiencing a psychiatric crisis that, without intervention, would result in hospital admission.

You can get information on any of these services, or on any aspect of mental health care in Croydon, including how to access services for yourself or the person you care for, by contacting the SLaM Information Line (0800 731 2864) 24 hours a day, seven days a week. If you experience any problems with the service the person you are caring for is receiving, or need more information regarding SLaM, contact SLaM PALS on 0800 731 2864 (same number as the information line).

The Books on Prescription Scheme aims to help Croydon residents with mild to moderate mental health issues, for example panic attacks, eating disorders, anger or obsessive behaviours, by offering GPs the opportunity to prescribe to their patients self-help guides available from Croydon libraries. Carers may also find this a useful source of information.

There are a number of organisations supporting carers of people with mental health problems, see Information for details.

Drug and Alcohol Services

If the person you care for has a drug or alcohol problem there is a range of support available from health providers, as well as voluntary organisations that are listed in chapter one.

The Croydon Substance Misuse Team (020 8604 7104) provides a comprehensive service to adults aged 18 and over; the team offers rehabilitation programmes, assessments of need, medication, access to a psychologist and much more. Children and young people under 18 can be referred to the Child and Adolescent Mental Health Service(020 3228 0000) by a professional such as a GP.

For more information on these or other drug and alcohol services in Croydon call the Drug and Alcohol Action Team (020 8726 7750, www.croydondaat.org.uk).

Managing Someone’s Medication

If the person you care for is taking medication but has mislaid the patient information leaflet that came with it, you could go back to the pharmacy that dispensed the medication or you may find it helpful to visit www.emcmedicines.org.uk. This is an electronic medicines compendium, and contains information about all UK licensed medicines, including physical descriptions, side effects and any interaction with other medication.

To help manage the storage and dispensing of medication, you can obtain handy storage containers such as those with the days of the week marked, and pill cutters, from equipment suppliers such as Care Providers (020 7997 6600, www.care-providers.co.uk) which sells and leases a number of care and mobility products (and provides domiciliary care). See Practical Help for other equipment providers. Boots Medisure Service is a free scheme whereby prescribed medication can be put into separately marked blister packs labelled with the time of day when the tablets should be taken. You can register for this service at the pharmacy counter in any Boots pharmacy. Pillbox UK (0800 112 3147, www.medicineblisterpacks.co.uk) is a registered UK pharmacy specialising in dispensing prescription medication into easy to use disposable pill boxes. This service is free of charge, delivered to your home and available to anyone with an NHS prescription.

Palliative Care

For people living with a life-limiting or life-threatening condition, support is available from Croydon Social Services and possibly from NHS continuing healthcare (see above). Croydon residents also have access to hospice services such as in-patient care, home nursing and emotional support. Palliative care services do not just focus on the person with the condition, they support families and carers as well, often through the bereavement process and beyond. Croydon Crossroads (020 8688 4499) works with Macmillan Cancer Relief to provide services to carers of children and adults with palliative care needs. The service offers a comprehensive range of practical and emotional support, designed to support the carer and help the cared for person remain in their own home for as long as possible. Children with palliative care needs may receive support from the Children’s Hospital at Home Team (020 8714 2501) which offers nursing care, continuing care and play therapy for children with palliative care needs. It also provides emotional support for children with a life-limiting condition and their siblings via the Willow Children’s Bereavement Service (020 8714 2501).

If the person you care for needs hospice care, they will be referred by a healthcare professional, such as their GP or hospital staff, and the hospice they can go to will depend on where they live. The Hospice Information Service (020 7520 8222, www.helpthehospices.org.uk) provides information about hospice care and how to find a hospice.

Adults living in the London Borough of Croydon may be referred to St. Christopher’s Hospice (020 8768 4500, www.stchristophers.org.uk) which offers in-patient care, home nursing and a comprehensive social work, welfare benefits and bereavement service to adult patients, their carers and relatives. Chlidren may be referred to Shooting Star CHASE (01483 230 960, www.chasecare.org.uk) which works with children and young people aged 0-19 and offers in-patient care at Christopher’s Children’s Hospice as well as home care and practical and emotional support to the family through bereavement and beyond. The Rainbow Trust Children's Charity (01372 453 309, www.rainbowtrust.org.uk) works with children and young people aged 0-18 and offers practical and emotional support via their family support workers, and breaks at their two respite houses.

NHS Costs and Transport

Most NHS treatment is free, but charges are made for prescriptions and services such as sight tests and dental treatment. Some groups of people, such as those aged 60 and over and people with certain medical conditions, are entitled to access some or all of these services for free. If you do not fit into one of these specified groups and you or your partner are aged 16-59, on a low income and/or receive certain means-tested benefits you may qualify for exemption from NHS health charges under the NHS Low Income Scheme.

Under this scheme you may also be able to claim back transport costs for journeys to receive treatment at an NHS hospital under a consultant, or through referral by a doctor or dentist. You should be able to claim your travel expenses at the hospital where you have your treatment, but if not, ask them for an HC5(T) refund claim form. Refund claim forms are also available for other services such as sight tests and prescriptions. For further information about help with NHS health costs, and to request claim or refund forms, call Help with Health Costs on 0845 850 1166.

If you do not qualify for free prescriptions, a prescription pre-payment certificate can save you money if you have to pay for more than three prescription items in three months, or 14 items in 12 months. For more information call 0845 850 0030.

Consent, Access to Medical Records and Complaints

Within the law, anyone aged 16 or over who has mental capacity, and can therefore make their own decisions, should be asked for their consent before they undergo any medical treatment (except in emergencies). If someone does not have mental capacity another person can give consent on their behalf, for example if they hold a lasting power of attorney. For full details on mental capacity and lasting power of attorney contact the Office of the Public Guardian (0300 456 0300, www.publicguardian.gov.uk). Children aged 15 and under are not deemed to have capacity, so parents or guardians can give consent on their behalf.

Everyone, including children, has the right to view their medical records under the Data Protection Act 1998. If you want to access someone else’s medical records you will need their consent, unless they lack capacity, or you hold a power of attorney for them. If you are a parent and want to access your child’s medical records you will also need your child’s consent if they are considered capable of making decisions about his/her medical treatment – this is often age 16 but can be younger. It is recommended that you apply in writing if you wish to view any records; there is usually a charge and you may need proof of identity. If you or the person you care for are refused access to your medical records, or you are unhappy with their content, you can make a complaint to the record holder. If you are still dissatisfied after this, you can approach the Information Commissioner’s Office (0303 123 113 or 01625 545 745, www.ico.gov.uk).

If you need to make a complaint about any NHS service the first place to go to is the Patient Advice and Liaison Service (PALS) for that organisation. If PALS cannot help then the Independent Complaints Advocacy Service (ICAS) (0300 456 2370, www.pohwer.net) offers information and practical support with NHS complaints such as help with writing letters and attending meetings.