Jen Kenward emphasises that unpaid carers are vital to sustaining our health and care systems, and without them, we simply would not cope

This year marks the sixth year that NHS England have sponsored an HSJ Award shining a light on the systems that work to improve the health, wellbeing and access to services for unpaid carers. But why does this matter?

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In the last census (2011), data showed that there were around 5.5 million people in England providing care to relatives or friends who would not cope without their support. Of this group, approximately 1.4 million people were providing in excess of 50 hours of care per week. The census data at that time suggested that the number of carers was also growing faster than the rate of the population.

Research conducted by Carers UK, based on these figures, suggests that the value of unpaid carers to the health and care system is around £132 billion per year – given that this roughly equated to the annual budget of the NHS, it is fair to say that unpaid carers are vital to sustaining our health and care systems. Without them, we simply would not cope.

Many of us who become carers do so incrementally, helping out in small ways to begin with and then, before we know it, finding ourselves embedded in caring for someone (often more than one person) and it becomes second nature to take on what can be a challenging, often frustrating, frequently exhausting, but also precious role in supporting someone close to us.

Caring comes at a cost

However, caring can come at a cost. The GP Patient Survey provides clear evidence that the health of unpaid carers is significantly poorer than that of their non-carer peers. Carers will often focus on the wellbeing of the person they support, rather than their own needs. The GPPS clearly shows how the mental and emotional wellbeing of carers suffers, and that carers are more likely to experience issues with their respiratory health, have muscular and skeletal injuries, have an increased incidence of diabetes and struggle to access primary care services around their caring responsibilities.

NHS England is driving forward initiatives which highlight system based arrangements, which embed the timely identification and support of carers within their core workstreams that focus on effective support within primary care, provision of contingency plans, creating a more inclusive offer for carers from vulnerable communities and ensuring that young carers are integral to these plans

The census data from 2011 suggests approximately 10 per cent of the population were carers at that time. The GPPS, however, saw 17-18 per cent of respondents identify themselves as unpaid carers. This is a significant cohort of people, covering all ages who experience inequalities in their health outcomes. Since the inclusion of 16- and 17-year olds in the GPPS, concerning evidence is emerging on the impact of caring on young and young adult carers (16-24-year olds) where the inequality gap in health outcomes is at its greatest.

Fast forward to 2021 and we have seen the number of carers grow substantially and cope with health and care systems withdrawing or changing how services have been delivered as the covid-19 pandemic has taken hold. There have been some positive changes, but significant challenges for carers, many of whom have had to cope in isolation. We have seen the important inclusion of unpaid carers in the priority groups for covid-19 vaccination, but we have also seen carers struggling to have their caring role registered with their GP practices.

The long-term plan set out clear commitments for the NHS to improve the identification and support of unpaid carers. Building on the rights created by the Care Act and the Children & Families Act and reflecting the ambitions being set out for the delivery of services across integrated care systems.

NHS England is driving forward initiatives which highlight system based arrangements, which embed the timely identification and support of carers within their core workstreams that focus on effective support within primary care, provision of contingency plans, creating a more inclusive offer for carers from vulnerable communities and ensuring that young carers are integral to these plans.

The “System Led Support for Carers” award recognises and celebrates integrated care systems who have understood the complexity of issues experienced by unpaid carers, worked in partnership with social care, voluntary sector colleagues and carers themselves to shape and deliver the services that matter to carers and enable them to manage their own health and well-being.