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					                    PCT Performance Indicators and Carer Support

Target                   Issues for carers           Suggestions            Impact
Access to a GP           Can be difficult for        Fast tracking of       Bad access to the GP
Percentage of patients   carers due to the way       carers appointments    can have a negative
able to be offered a     respite services work.      so that the care       impact on both the
routine appointment                                  package doesn’t        patient and the carer.
to see a GP within                                   break down.            Flexible access would
two working days.                                    A carer register to    lead to satisfaction with
                                                     help GPs know who      the GP services. Swift
                                                     needs flexibility.     access may lead to the
                                                     Identification of      prevention of more care
                                                     carers should lead     services being needed
                                                     to referrals an        later.
                                                     appropriate agency.    Services provided by
                                                     See also House of      Carers’ Centres takes
                                                     Commons Public         pressure of GP time,
                                                     Accounts               enabling a larger
                                                     Committee report       percentage of patients
                                                     “Improving             to be offered a timely
                                                     Services for Older     appointment.
                                                     People” (HC626)
Access to a primary      As above                    As above.              As above.
care professional                                    Carers have also
Percentage of patients                               found walk in
able to be offered a                                 centres helpful e.g.
routine appointment                                  quick access to an
to see a primary care                                OT
professional within
one working day.
Drug misuse:             Is alcohol misuse           These hidden carers    The gentle approach by
Treatment                included here?              can be identified      Carers’ Centres
Increase in drug         Carers of drug misusers     through schemes        working with families
misusers accessing       are a group who are         such as that in        can encourage users to
treatment                reluctant to come           Nottingham.            come forward for
                         forward due to perceived                           treatment
                         Carers suffering from
                         depression as a result of
                         their caring role may
                         lead to misuse of anti
                         Issues for young carers
                         caring for someone
                         misusing drugs.
Target                   Issues for carers             Suggestions             Impact
Financial                General cost and time                                 Supporting carers saves
management               saved by carers within                                on costs of immediate
Achievement of the       primary care at the                                   care and long term care
financial position       moment can be                                         of both the patient and
shown in the 2003/04     maintained and increased                              possibly the carer
Plan, submitted to the   by effective carer support                            themselves.
Department of
Health, without the
need of unplanned
financial support.
Four-week smoking        Carers whose health has       General carers
quitters                 been damaged by               support can help to
Number of smokers        smoking can lead to a         reduce stress levels,
who quit at four-        costly care package if        which may be
week follow up with      they are unable to            linked to smoking.
the NHS smoking          continue.                     Carers’ Centres can
cessation services.      Carers are amongst the        provide neutral
                         most deprived groups in       space to hold
                         society and there are         smoking cessation
                         strong links between          sessions (as in
                         deprivation and smoking.      Reading)
                         Carers often feel stressed    The network of
                         which can lead to             centres can also
                         smoking, or make it           publicise smoking
                         difficult to stop.            cessation services,
                                                       and offer stress
                                                       relief to carers
Improving working        1 in 8 working people are     Carer friendly          Flexibility allows carers
lives                    carers – this may be          policies at work        to balance their work
Continued                higher within the NHS         e.g. flexible           life with their caring
implementation of the    where former carers may       working policy.         commitments, bringing
Improving Working        have retrained.                                       benefits for both
Lives Standard           Carers are a source of                                employer and
                         future employment                                     employee.
                         generally. Their caring
                         experience may make
                         them more likely to
                         follow a career in the
                         care industry. The NHS
                         particularly has a
                         challenge in the future to
                         keep up staffing levels.
                         Carers as partners in care.                           Allows carers to care
                                                       Training for carers     effectively and safely,
                                                       in recognition of       and provides skills for
                                                       their role as partner   future employment,
                                                       in care.                possibly within the
                                                                               NHS. Takes pressure
                                                                               off professionals and
                                                           saves time and money.

Target                   Issues for carers   Suggestions   Impact
Outpatients waiting                                        Waiting longer than 21
longer than the                                            weeks for an
standard                                                   appointment is likely to
Measurement of the                                         cause anxiety and stress
breaches of the 21-                                        to carers and increases
week target for first                                      danger of the care
outpatient                                                 package breaking
appointment                                                down.
throughout the year                                        Carer support as
and the measurement                                        "partners in care" can
of breaches of the 17-                                     lead to less outpatient
week target for first                                      treatment helping PCTs
outpatient                                                 meet 21 week and 17
appointment as at 31                                       week targets
March 2004.

Patients waiting                                           Carer’s health can play
longer than the                                            a vital role in keeping
standard for elective                                      the person they care for
admission                                                  free from infection,
Measurement of the                                         thus reducing care costs
breaches of the 12-                                        later.
month target for an                                        Less admissions
elective inpatient or                                      through falls etc if
day case admission                                         carers are supported to
throughout the year                                        care.
and the measurement                                        Prevention of
of the breaches of the                                     readmission if carers
9-month target for an                                      are involved at point of
elective inpatient or                                      discharge, and
day case admission as                                      supported via Carer
at 31 March 2004.                                          Centre referral -
                                                           reduces pressure on
                                                           elective work.
Total time in                                              Effective carer support
A&E:less than 4                                            and training may help
hours                                                      reduce the reasons for
Percentage if patients                                     A&E admissions thus
waiting less that four                                     reducing numbers and
hours in A&E from                                          consequently waiting
arrival to admission,                                      times.
transfer or discharge.
Balanced Scorecard Indicators:

 Target                  Issues for carers            Suggestions            Impact
 CAMHS                   (i) Carers need to be        (i) Identify hidden
 Child and adolescent    included in process.         carers through work
 mental health           Parent and young carers      with patients, for
 services (CAMHS):       would be the main            example parent
 (i) audited needs       population for this.         carers.
 assessment for the
 population (ii)                                      Work with Partners
 increase in                                          in Care programme.
 investment in
 CAMHS against
 target expected
 Cervical screening      Ineffective screening        Support carers in      General preventative
 Percentage of women     potentially creates more     thinking about their   health care can prevent
 aged 25 –64 screened    carers.                      own health needs       more people needing a
 for cervical            Carers need encouraging      and encourage          carer.
 abnormalities           to look after their own      regular screening.     Maintaining carers
                         health as they are           Check for cancer       health has a positive
                         unlikely to out their own    collaboratives.        impact on future health
                         health needs first.                                 costs for both carers
                         (Morbidity study)                                   and the people they
                                                                             care for.
 CHD Register            It is important for carers   Ensure that carers     Investment in carers
 Clinical audit data     to be involved in this       are involved and       leads to better overall
 that describe the       process. For instance diet   consulted in the       patient care and
 provision of            is an important factor and   process.               improvement in carer
 appropriate lifestyle   carers are often in charge   Invest in carer        health and stress levels.
 advice and systematic   of this. Carers are also     support in terms of
 treatment regimes       often heavily involved in    advice and
                         patient compliance with      information.
                         prescribed drugs.
                         Stress levels of both
                         patient and carer can be
                         positively affected by
                         effective lifestyle
 Child protection        Young carers may have        Recognise and
 Compliance to           potential child protection   support the role of
 recommended child       issues, e.g. young carers    carer support in
 protection systems      caring for over 50 hours     training
 and procedures          per week.                    professionals, and
                                                      link with young
Target                  Issues for carers             Suggestions           Impact
Community               A lot of equipment will       Involve carers in     Good and appropriate
equipment               be used directly by carers    the assessment        equipment has a
Percentage of items     and so needs to be            process to ensure     positive impact on both
of equipment and        appropriate for their         that equipment is     the carer and the
adaptations delivered   needs as well the             appropriate for all   patient, and helps to
in seven days           patient’s. Equipment has      involved the first    ensure that carer’s
                        a direct impact on carers     time round.           health is maintained,
                        health and well being         Ensure that carers    allowing continued
                        with non appropriate          are trained and       independence for both.
                        equipment causing             know how to use       Carers can help with
                        problems such as stress       equipment.            continence
                        and back problems.                                  management if
                        There are strict                                    supported correctly.
                        guidelines regarding
                        moving and handling and
                        it is illegal for carer
                        workers to do so alone.
                        Carers do not have the
                        same protection.
                        Continence – more
                        people go into long term
                        care due to continence
                        problems than anything
Death rates from        As CHD and cervical                                 Carers’ Centre support
cancer                  screening.                                          can promote life style
Percentage change in                                                        changes for carers and
mortality rates from                                                        their families.
all malignant
neoplasms in people
aged under 75 per
1000,000 population.

Death rates from        As above but more so as
circulatory diseases,   carers can play a vital
ages under 75           role in prevention of such
Percentage change in    problems due to things
mortality rate from     like diet. Carer support is
all circulatory         vital in this.
diseases in persons
aged under 75 per
100,000 population.
Target                Issues for carers             Suggestions            Impact
Delayed transfers of  This is a very important      Ensure that the        An effective and
care                  issue for carers who may      result of cutting      appropriate discharge
Percentage of patientsbe charged for                delays does not        procedure ensure that
whose transfer of     intermediate care due to a    result in the burden   carers are able to
care from hospital    loophole in the system.       falling onto carers    continue providing care
was delayed.          This can lead to              and that discharge     and that readmissions
                      inappropriate care and        is appropriate for     are likely to be reduced.
                      have detrimental effects      all involved.
                      on carers own health.
                      Conversely carers can
                      help the process to ensure
                      that it is a positive
                      experience for all.
Diabetic retinopathy As CHD and other
screening             condition related targets.
Drug misuse: shared Carers should be an
care                  integral part of the
Percentage of GP      rehabilitation and
practices in a shared treatment process and can
care scheme for       provide valuable
problematic drug      information.
misusers              Possible links with
                      Partners in Care
Flu vaccinations      As CHD and other              Carers to be a core    Benefits of maintaining
Persons vaccinated    condition related targets.    group of those         and improving carers
against flu as a                                    entitled to            health.
percentage of the                                   vaccinations.          Carers have direct
number of people                                    Involve carers in      influence on many
aged 65 and over.                                   the promotion of       target groups for
                                                    available vaccines.    vaccines and can help
                                                                           to increase numbers.
GP appraisal             Not relevant
Percentage of GPs
appraised during
Health equity audit      Carers are often an
Assessment of the        excluded group because
effective use of         they are carers. Their
health equity auditing   health can be negatively
in service planning,     affected by their caring
commissioning and        and they also have the
delivery in order to     power to positively affect
tackle health            the health of others.
inequalities.            Carers’ Centres in a good
                         position to know areas
                         where the inequalities
                         exist and are involved in
                         Social inclusion work.

Target                   Issues for carers            Suggestions            Impact
Immunisation             Not relevant
Percentage of 2-year-
old children who
have received the
MMR vaccine.
Infant health            Carers are likely to         Support and            Supporting carers
                         neglect their own health     encourage carers to    throughout and post
                         needs – including carers     look after their own   their pregnancy can
                         who are pregnant.            health needs.          help ensure the health
                                                                             of both mother and
                                                                             child, having positive
                                                                             health benefits and also
                                                                             enabling the
                                                                             continuation of care.
NHS dentistry            Carers are likely to         Support and            Supporting carers and
Access to NHS            neglect their own health     encourage carers to    the people they care for
dentistry                needs.                       look after their own   to have regular check
                         Carers also have a direct    health needs.          ups may help prevent
                         influence on the person      Support carers to      further, more costly and
                         they care for in terms of    access services by     time consuming
                         them accessing such          being flexible with    treatment later on.
                         services.                    appointment times
PCT commissioning        Carers as partners in care   Involve carers.        Commissioning will be
of NHS Plan              can help to ensure an        Work with Partners     more effective and cost
deliverables             appropriate care plan.       in Care campaign.      effective if carers are
Mental health (adults)   Carers as potential                                 involved.

PCT patient survey:      Carers as both carers and
access and waiting       patients. Satisfaction
                         levels are likely to be
                         reflected by the person
                         they care for.
PCT patient survey:      As above
better information,
more choice
PCT patient survey:      As above
building closer
PCT patient survey:      As above
clean, comfortable,
friendly place to be
PCT patient survey:      As above
safe, high quality,
coordinated care

Target                   Issues for carers          Suggestions             Impact
Prescribing: mental      As above.                  As above                Carer support in terms
health                                              Work with Partners      of their own health will
                                                    in Care campaign        reduce prescribing
                                                                            rates, dependence on
                                                                            drugs, increasing
                                                                            quality of life and the
                                                                            quality of care.
                                                                            With carer input the
                                                                            effectiveness and
                                                                            appropriateness of
                                                                            drugs can be improve.
Sexual health:           Young carers may be a      Appropriate support     Lower the vulnerability
access to services for   vulnerable group.          and services for        of young carers as a
early unintended                                    young carers.           group.
Single telephone                                                            As with drop in centres,
access                                                                      flexibility and a quick
Single telephone                                                            response is invaluable
access through NHS                                                          for carers
Direct to GP out-o-
hours care
Six-month inpatient      As with A&E.                                       A healthy patient and a
waits                                                                       healthy carer will help
Number of patients                                                          to reduce waiting list
who had been waiting                                                        numbers.
less than 6 months for
inpatient treatment as
quarter-end as a
percentage of the
number of patients on
the inpatient waiting
Staff opinion            Not relevant
survey: health, safety
and incidents
Staff opinion            Carers as partners in care Recognition of
survey: human            and therefore a part of    carers as partners in
resource management     NHS HR                care.
                        Carers as potential
Staff opinion           Not relevant
survey: staff attitudes
Suicide audit           Not relevant
Local system for
suicide audit
Teenage pregnancy Young carers may be a
Conceptions below       vulnerable group
age 18

Target                  Issues for carers     Suggestions   Impact
Workforce datasets:     Not relevant
data quality on
ethnic group
Completeness of trust
coding for ethnicity
in workforce datasets

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