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Can compassion and QOF coexist? 'Severe depression; the essential guide for carers' by Tony Frais

We need to sift through all the paperwork to rediscover why we went into general practice, says Dr Clare Etherington

In the morass of QOF and CQC documentation that I have recently ploughed through, I was delighted to be sent a leaflet about caring for someone with severe depression; ‘because I know you are interested in depression’. It is so easy in the current busy world to read only what we need to fulfil targets or tick a box for appraisal.

Tony Frais, who has been treated himself for severe depression, has written a booklet specifically aimed at the carers of people who have severe depression. He aims it to be a bridge between very short patient leaflet and long self-help books. He has self-published the booklet on Amazon and you can read for yourself by using the ‘search inside this book’ feature.

Some of the information describing depression and its treatment is what you would expect in a booklet about depression, but the unique points are the sections on the impact on carers and the focus on carers looking after themselves. Research is quoted demonstrating that patients with severe depression who are cared for by carers who deal well with the carers’ role may have shorter episodes of depression; conversely patients who live alone are more likely to commit suicide. The language is simple and the booklet smacks of being written by someone who has experience of depression. The narrative is interspersed with quotes from carers, giving a personalised aspect. Although it is aimed at carers, I wondered if it would also be useful to patients; perhaps giving them a different perspective on their illness and how it might impact on people close to them. If you happen to teach I think it would make a great starting point for a tutorial for medical students or registrars.

The RCGP is promoting a focus on caring for carers. Clare Gerada recently described carers as a ‘critical asset’. I think those who care for people with severe depression probably are heroes even less sung.

QOF is not all bad; from your data you should know how many patients who suffer from severe depression you have on your list. I wonder if you know who cares for them. How about doing something different one evening; put your CQC standards or QOF targets to one side and read this booklet.

In a world of rationing there are some patients who need our care more than others. You could start small and begin by offering help to the carers of your patients with severe depression. We all went into medicine to make a difference to our patients; sometimes it behoves us to remember the ‘caritas’ of the College motto. Out of QOF data let’s find some compassion.

Dr Clare Etherington is a GP in Harrow, North-west London

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