Ann Richards and her colleagues hit the nail on the head when they said, 'general practice needs to overcome. . .

its aversion to new activities which contain no financial incentives' ('Eye off the ball', page 27, 25 January).

For the past two years, I have been trying to engage GP practices in Bolton in a project to identify which of their patients have caring responsibilities. This is in line with recommendations in national planning guidance, and in the national service framework for mental health:

GP practices must identify their carers, so that appropriate support can be offered.

Like Ann Richards, I have come up against significant resistance, particularly around fears of increased workloads, lack of interest and because there is no extra remuneration for practices. Recently I have been able to engage practices in a particular primary care group area of Bolton by working in partnership with the PCG to produce a pack which helps practices with the practicalities of identifying and supporting carers.

However, one of the key factors is agreement from the PCG to reimburse practices for administration hours spent compiling practice-based carers' registers. This is despite other incentives such as the free pack, free carers' leaflets for patients, and free support from me as carers linkworker.

Despite the progress made in Bolton, GPs and other primary care professionals have still to fully recognise their vital role in identifying and supporting carers. For many carers, their GP is the only professional with whom they have contact. If GPs are not fulfilling their responsibility to signpost carers to local sources of support, these carers may struggle on, not knowing help is available.

Lisa Smith Carers linkworker Bolton Carers Support