Social care system would collapse without unpaid carers, report says

A new report by the King’s Fund is calling for more support for unpaid carers, after research found that without them, the social care system would collapse.

Indeed, unpaid carers contribute the equivalent of four million paid care workers to the social care system. Unpaid carers care for people who could not cope without support, yet only around a quarter of these cares receive Carer’s Allowance, leaving the majority without financial support.

The research found that fewer carers receive paid support (such as direct payments, personal budgets and commissioned support) now (27%) compared to in 2015/16 (31%). Instead, carers are being increasingly offered advice, information and signposting (56% compared with 50% in 2015/16).

The number of people provided with respite care delivered to support their carers has also fallen from 57,000 in 2015/16 to 33,000 in 2021/22.

This means unpaid carers are receiving less support now than they were eight years ago, despite contributing 7.9 billion hours of social care each year.

Unpaid caring has a health impact as well as an economic impact

The Personal Social Services Survey of Adult Carers also found that carers reported a range of health conditions relating to their caring duties.  Many reported feelings of tiredness, stress, disturbed sleep and depression, while nearly half also reported financial difficulties due to their caring role.

This impact increased according to the number of hours spent caring, with 80% of adults providing 20 or more hours of care reporting at least one health impact, compared with 38% of those who provided less than one hour of care.

Many of the carers interviewed told the report’s authors that access to good health and social care for the person they are caring for is vital for their own quality of life, and the impacts of ongoing funding issues and the health and social care workforce crises was putting added strain on their wellbeing.

The report is therefore calling for health and social care systems to be as integrated as possible, to reduce the burden on unpaid carers as much as possible. However, improving healthcare access will only go so far to improving carers’ wellbeing.

Unpaid carers are a diverse group with diverse needs

The authors of the report have developed a taxonomy of types support for unpaid carers, which is grouped into three broad categories:

• Support to carer – interventions that are solely delivered to the carer (such as employment and financial support)
• Support to carer and the person they care for – interventions that might be delivered to the carer and/or the person they care for, but still provide support to the carer (such as respite and breaks from caring, digital technology assistance, and information and advice about entitlements, support and services).
• Wider interventions – other aspects we noted from the literature of the wider context of support for unpaid carers, but not necessarily delivered directly to carers (such as housing support, and involvement of carers in design and planning of services).

This taxonomy shows the array of support that can be offered to unpaid carers and the people they care for, and also highlights that unpaid carers have diverse needs, and local authorities should avoid taking a one size fits all approach.

Instead, interventions should give adequate attention to the carer and the person they are caring for, as perspectives, needs and preferences can differ.

Commissioners and services therefore need to develop and maintain a good understanding of their populations, the report states. This can be facilitated by:

• Supporting local professionals to identify carers and signpost them to available services;
• Meaningfully measuring the impact of support; and
• Engaging with local carers.

Improving the quality and extent of the care being provided

Deborah Fenney, co-author of the report, said there now needs to be a shift in thinking so that local authorities are able to understand and support unpaid carers in the most effective way possible.

“Our report highlights that unpaid carers contribute the equivalent of four million paid care workers to the social care system and without them the system would collapse.

“Carers say they often struggle to find out what support is available, and it is a complex system to navigate.

“On top of this they are experiencing pressure from the wider issues the health and social care sector is currently facing.

“Unpaid carers said repeatedly that what most mattered to them – and what would make the greatest difference to their lives – was an improvement in the quality and extent of the care being provided for the person they were caring for,” she said.

Lauren Nicolle

Lauren is a qualified journalist who writes primarily across the health and social care sectors. She is passionate about exposing the injustices faced by people with a learning disability, with a particular focus on equal access to healthcare.

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