JSNA > Living Well

‘Unpaid carers provide critical support for people with health and social care needs’ (Caring as a social determinant of health: Findings from a rapid review of reviews and analysis of the GP Patient Survey, Public Health England, March 2021). They are a critical asset within our communities and provide vital support to family members, friends and neighbours.

The Department of Health and Social Care (DHSC) describes an informal/unpaid carer as “someone who provides unpaid help to a friend or family member needing support, perhaps due to illness, older age, disability, a mental health condition or an addiction, as long as they are not employed to do so”. The Carers Trust describe a carer as ‘…anyone who cares, unpaid, for a friend or family member who due to illness, disability, a mental health problem or an addiction cannot cope without their support’.

Carers UK estimates that there are around 6.5 million people across the UK that provide care and support to a loved one who is older, disabled or seriously ill. That’s roughly 1 in 8 adults who provide unpaid care for family or friends. ‘Valuing Carers 2021’ (Carers UK) estimated that in 2021 the economic value of the contributions made by carers in England and Wales was £162 billion per year, 29% more in real terms than 2011. The health and social care system heavily relies on the dedicated unpaid caregivers, without whom it would struggle to meet the crucial needs of those requiring care and support. A significant number of these caregivers may not realize their role or acknowledge themselves as such, resulting in missed opportunities to access the support available for them.

Key messages

  • According to the 2021 Census there were around 52,700 unpaid carers in County Durham. 
    •  This is around 10.6% of residents aged 5 and over.   
    •  This is down from almost 59,800 in Census 11, a fall of 13.0%.  
  • Census 2021 also showed the number and proportion of those in poor health providing unpaid care increased in each age band compared to Census 2011. 52% of those aged 65+ and providing unpaid care described themselves as being in poor health in Census 2021 compared with 17% in Census 2011.
  • The Carer reported Quality of Life Score (2021/22 – latest available data) for County Durham was 8.2 out of 12. Higher than regional and national comparators.
  • 74.9% of carers reported their caring role had not caused any financial difficulties in 2021/22, compared to 57.2% in England. 
  • Almost half of our carers feel they have had as much social contact as they want with people they like (41.9%).

Why is it important?

Carers are a critical asset within our communities and provide vital care and support to family members, friends and neighbours.

They play a key role in holding families together, filling the space that statutory services cannot. The contribution to society that carers make is immense, and whilst this can be hugely rewarding it can often come at a great personal and financial cost to themselves.

The introduction of The Care Act 2014 and the Children and Families Act 2014 put in place new rights for carers, including a focus on promoting carer wellbeing and placed a responsibility on Local Authorities to prevent, reduce and delay the need for support. Carers are entitled to an assessment of their own, giving carers the right to receive support. Local councils have a duty to provide information and advice to carers in relation to their caring role and NHS bodies also have a duty to cooperate and partner with local authorities in delivering the Care Act functions. (Carers Trust) .

Many carers do not recognise themselves as a carer which means they are not accessing the support available to them. Many carers see themselves primarily as a partner, family member or friend and this can often be a barrier to people asking for help.

We know that carers face poorer health outcomes, with a high proportion of carers struggling with mental and physical health problems, and experiencing low levels of wellbeing. There are also financial implications associated with caring, with carers often using their income or savings to pay for support services and care equipment. Almost two-thirds of carers worry about managing their monthly costs and many worry about how they can stay in employment as they face the challenges of juggling work and caring responsibilities.

Recent findings from The Health Foundation (April 2023), ‘Understanding unpaid carers and their access to support’ includes the following findings:

  • Only a small % of carers approach their local authority for help, with only 8% of carers accessing help in 2021.
  • 1 in 5 carers report feeling socially isolated.
  • 4 in 10 carers report financial difficulties because of their caring role.
  • 4 in 10 working age carers are not working as much as they might do otherwise due to their caring role.
  • Carers providing more than 20 hours of care a week are also more likely to live in lower income households than non- carers.
  • Most people will have caring responsibilities at some point in their lives and half of all people will provide care before the age of 50.
  • Identification of carers needs to improve to understand whether they are being supported effectively and to help target support.

Carers UK published their State of Caring 2023: The impact of caring on health’ report which found that:

  • 82% of carers said the impact of caring on their physical and mental health would be a challenge.
  • 79% of carers said that they feel stressed or anxious and 40% said that they feel depressed.
  • 50% of carers said they feel lonely.
  • 44% said they put off health treatment because of their caring role.
  • 54% of carers said their physical health had suffered.

The APPG for Young Carers and Young Adult Carers and Carers Trust published the first ever Parliamentary inquiry report which found:

  • Being a young carer has a knock-on effect on school attainment and attendance, with young carers missing 27 school days per year on average.
  • Young adult carers are substantially (38%) less likely to achieve a university degree than their peers without a caring role.
  • Young adult carers are less likely to be employed than their peers without a caring role, particularly if they are providing significant levels of care.
  • Young people with caring responsibilities are more likely to self-harm than young people without caring responsibilities. Of children who do self-harm, young carers are twice as likely to attempt to take their own life than non-carers

Links to Strategies and Plans

  • Local Joint Health and Wellbeing Strategy 2023-28
  • Carers Plan on a Page 2023 – for Adult Carers, Parent Carers and Young Adult Carers
  • Carers Plan on a Page 2023 – for Young Carers
  • County Durham Place Based Commissioning and Delivery Plan 2020-2025 3rd edition
  • NHS Long Term Plan
    • Section 1 outlines the NHS’ plan to boost ‘out of hospital’ care, dissolving the divide between primary and community health services. There is greater recognition and support for carers to address individual health needs by introducing best-practice Quality Markers for primary care. The Quality Markers highlight best practice in carer identification and support (Section 1.19)
    • Section 2 pledges stronger NHS action on health inequalities, including identification of, and support for, carers, particularly those from vulnerable communities (section 2.33):
      • Quality markers for carer-friendly GP practices. Developed with the Care Quality Commission (CQC), these will help carers identify GP services that can accommodate their needs.
      • The national adoption of carer’s passports will identify carers and enable staff to involve carers in patient care.
      • Developments to electronic health records will allow people to share their caring status with healthcare professionals wherever they present.
      • Ensuring more carers understand out-of-hours options and have appropriate back-up support in place if needed. ‘Contingency planning’ conversations and plans will be included in Summary Care Records, allowing professionals confidence to know when and how to call those plans into action when needed.

Evidence base ‘what works’