Making sense of the unexpected drop in the numbers of unpaid carers

Sometimes data surprises us. According to new data out recently from the latest national census, the numbers of unpaid carers in England and Wales have gone down not up in the last 10 years – from 5.8 million people in 2011 to five million in 2021. This will come as a surprise to many, so how should we make sense of it?

What does the data tell us?

The national census is one of the most trustworthy sources of data on unpaid carers, and the new figures reveal some important information about the landscape of caring, including how this is changing over time.

The headline finding is that there has been an overall decline in the number of unpaid carers in England and Wales in the last decade – driven largely by a sharp drop off from 7.2% (2011) to 4.4% (2021) in the number of carers providing 19 or fewer hours of care a week. The data also shows, importantly, that there are now 1.5 million people in England and Wales providing 50 or more hours of unpaid care a week. 

It also reveals that the largest growth is among carers providing very high levels of care – a trend also seen in the previous 2011 census. This represents an increase of 152,000 people providing 50 or more hours of care each week compared to a decade ago.

This change is important because studies show that for people providing 50 hours or more of unpaid care a week, the health impact of being a carer is equivalent to losing 18 days of full health each year. 

The breakdown of census data by local authorities also raises important questions about the concentration of high levels of unpaid caring, disability and social deprivation in certain areas, such as in Neath Port Talbot in Wales and in local authorities in the north of England. This suggests that the increase in the number of carers providing high levels of care is particularly visible in poorer areas.

Working harder with less support

Together with the new census data, recent analysis of national data by the Nuffield Trust shows that many carers are working harder, but with less support, than ever before. 

Our policy report reveals that the reality for unpaid carers has been one of diminishing help over time, with local authority gross expenditure on services for carers dropping by 11% in six years (2015/16 to 2020/21). During the same period, access to ‘direct support’ declined similarly. This means that, compared to six years earlier, by 2020/21 there were 13,000 fewer carers in England receiving the support and personalisation that ‘direct support’ is designed to offer.

This picture aligns with what carers say themselves when asked how the support they receive has changed over time. “I would say it’s got worse”, carer Sharon Tomlin explained to us.

If unpaid carer numbers are going down not up, should we be concerned?

Yes, in many ways this is a worrying trend. First, because according to historians and scientists, the compassion and empathy involved in caring for someone who needs help due to illness, disability or old age is one of the hallmarks of what makes us human.

Second, because policy-makers trying to shore up current problems in health and social care will rightly be concerned about any data showing an overall decrease in the number of unpaid carers.  From the perspective of the NHS and a struggling social care sector in England, the work unpaid carers do – worth billions of pounds each year – is essential in bridging gaps in state-funded support. 

This includes caring for people at home after they’ve returned from a stay in hospital – work that is crucial in helping to avoid unnecessary delays getting people out of hospital and which can lead to problems for ambulances at the front door and deterioration in those people unable to leave hospital. Falling numbers of unpaid carers raise clear questions about the sustainability of policy choices that rely heavily on unpaid carers to prop up a failing social care sector.

And third because this trend also bodes badly for pressure on public finances in the longer term. If fewer and fewer people are willing or able to take on the work of being an unpaid carer, in an ageing society this may have serious consequences for public finances – through increased demand for state-funded social care – as well as having implications for the health and dignity of those who need care.

Five million people making a huge contribution to society

Five million unpaid carers represent a huge number of people making a significant contribution to society, but the 2021 census data suggests policy-makers should be careful not to take them for granted. With an unexpected overall decline in the numbers of unpaid carers in England and Wales, perhaps the most important unanswered question is how can we better support the carers we have?