What are carers in each of the four UK countries entitled to?

Key points

• In each of the four UK countries, there is a strong and heavy reliance on informal carers. Figures from the census in 2021 estimate informal carers across the UK to be in the region of five million.
• Carers in each UK country are eligible for assessments by their local authority or health and social care trust. Eligible individuals are entitled to a support plan.
• Different initiatives have been undertaken to support carers and their wellbeing. Of note is Scotland’s Carer's Allowance Supplement, which brings Carer's Allowance in line with Jobseeker's Allowance.

Source: * Figures for England, Wales and Northern Ireland reported here are taken from the UK census (2021)⁵ and are the most recent comparable and accurate resource. Unpaid carers are counted as aged five and over. Figures for unpaid carers aged 16 and over are also available for Northern Ireland .

** Scottish census 2021 figures have not been published at time of writing. Most recent figures published by the Scottish government are derived from the Scottish Health Survey and cannot be directly compared with figures for the other UK countries. The Scottish Health Survey is calculated by applying the percentage estimate of carers from 2017-2021 to 2021 mid-year estimates. The Scottish government considers figures from the Scottish Health Survey to be a more accurate representation of people providing low levels of care, due to census data collection being at household level (rather than individual level). Unpaid carers are counted as aged four and over.⁶

A fall in the number of unpaid carers

Across the UK as a whole, there has been a fall in the number of unpaid carers. The fall in numbers has come as a surprise to many⁷ as other evidence suggests that the number of unpaid carers has increased during the Covid-19 pandemic.⁸ There has, however, been an increase in the number of people providing care for more hours in the week in Wales and Northern Ireland. In Wales, the majority of people providing care provided 50 or more hours of unpaid care, which is different from England where the majority of unpaid carers provided nine hours or less.⁹Moreover, a greater proportion of people provided unpaid care in Wales compared to England, at 10.5% and 8.9% respectively.¹⁰ In Northern Ireland, the number of people providing 50 or more hours of unpaid care each week has increased to 68,700, up from 56,300 people in 2011.¹¹ 63% of adult unpaid carers in Scotland provide 50 or more hours a week.¹²

England

The Care Act (2014) provided a new definition of a carer (“an adult who provides or intends to provide care for another adult”), and established duties for local authorities to provide an assessment and support to eligible needs.

As such, individuals providing informal care are entitled to a carer’s assessment by the local authority to determine how to support the carer’s needs and whether their role is sustainable in the long term. Carer entitlement is subject to national eligibility criteria if the local authority believes the carer has needs:¹³

1. Arising from the care and support provided to another individual
2. The carer is unable to achieve some of the outcomes listed in the eligibility regulations, or is at a risk of their physical or mental health deteriorating
3. The carer’s wellbeing is affected as a result of this.

Carers are also entitled to a Carer's Allowance if they care for someone at least 35 hours a week, which is administered by the Department for Work and Pensions. This is set to £69.70 a week(2022).¹⁴ While there have been calls to increase the Carer's Allowance in line with Jobseeker's Allowance (see Scotland), it seems unlikely this will happen in the near future. England has provided limited support to withstand the financial impact of the cost-of-living crisis.¹⁵ Claimants of the Carer's Allowance will not receive the £650 one-off payment to aid with the cost-of-living crisis – this is reserved to those who receive universal credit, tax credits and income support.

With strains on formal provision of care and a growth in need,¹⁶ the number of people in receipt of the Carer's Allowance is rising.¹⁷ Surveys of carers suggest that their welfare is decreasing as their workload becomes greater and their access to local support is reduced.¹⁸ The Department for Health and Social Care reports that some progress has been achieved against areas outlined in the 2020 Carers Action plan, with improvements to support unpaid carers in employment and better identification of unpaid carers by health and social care services.¹⁹ However, Nuffield Trust research²⁰ finds that support for unpaid carers in England has in fact diminished over time. Constraints on budgets and funding pressures, in addition to a lack of accountability and agreement on who is responsible for policy success and failure, are cited as some explanatory factors.

The government’s People at the heart of care white paper outlined some new policies to support unpaid carers, including up to £25 million to work with the sector to kickstart a change in the services provided to unpaid carers; and a new obligation for integrated care boards (ICBs) and NHS England to involve carers when commissioning care for the person they care for.²¹ The government-backed Carer’s Leave Bill is passing through parliament in 2023, and if successful will entitle eligible employees who currently provide care to dependent family members up to five days of unpaid leave.²²

Wales

Similarly to England, the Social Services and Wellbeing Act 2014 provides a new definition of a carer (“a person who provides or intends to provide care for an adult or disabled child”) and establishes duties to local authorities to provide support to carers on the same grounds as the person being cared for.²³

As such, the local authority has a duty to assess any carer and the carer’s ability and willingness to provide care and support to an individual. Any carer who meets the eligibility criteria (identical to the person in need of care and support) must receive a support plan from the local authority. As the Carer's Allowance is administered by the Department for Work and Pensions and is not devolved, rates of pay and eligibility criteria are identical to England, meaning eligible carers can receive £69.70 per week (2022/23).

Stakeholders and citizens’ reports such as Measuring the mountain have highlighted some positive examples of collaboration between local authorities and carer support groups, in line with the “values base” of the Social Services and Wellbeing Act. However, Carers Wales reports that in 2018/19, up to 55% of carers had not received the appropriate information and support the Act legislates. 85% of respondents had also not received a carer's need assessment in the past year, despite demand. The number of informal carers has been growing rapidly, with Wales having the highest proportion of young carers in the UK.²⁴

The Strategy for unpaid carers: delivery plan 2021 published in November 2021 outlined four priorities: identifying and valuing unpaid carers; providing information, advice and assistance to carers, supporting life alongside caring, and supporting unpaid carers in education and the workplace.²⁵

In addition, £7 million funding was announced in November 2021 with £5.5 million allocated to local authorities to provide targeted support to unpaid carers and £1.25 million for the Carers Support Fund.²⁶ To deal with the cost-of-living crisis unfolding in 2022, Wales invested £29 million to give 57,000 unpaid carers a one-off payment of £500 to help deal with costs and to recognise the “pivotal role” they have played during the pandemic.²⁷ Carers can also apply for grants up to £300 to pay for food, household items and electronic items.²⁸

Scotland

In Scotland unpaid carers²⁹ are protected under carer-specific legislation. The Carers Act 2016, which provides a definition of a carer, a young carer, and an adult carer (a carer is “an individual who provides or intends to provide care for another individual, the cared-for person”).

As such, the Act establishes duties for local authorities and health and social care partnerships to provide support for carers under a self-directed support plan, also specifically known as an Adult Carers’ Support Plan.³⁰ Local authorities have discretion to set the level of eligibility at which carers can receive support under a self-directed support plan, which in practice means there are different access thresholds (although most are set at a “substantial” need for support).

Despite this active recognition of the role of informal care in supporting service users, Carers Scotland³¹ reported in 2019 that implementation of the Carers Act has varied across Scottish regions, and many carers have struggled under financial pressure. The report also acknowledges the skew towards older and female carers, which stakeholders suggest could be the result of societal expectations.

An implementation plan for the Carers Act 2016 was published in 2021, and set out six key priorities over 2021-2023. These are strategy and leadership, legislation and guidance, workforce and systems support and development, raising awareness, carer involvement and choice, and measuring progress and impact.³²

To recognise carers’ contributions to the care of individuals and to the wider economy, the Scottish government introduced the Carer's Allowance Supplement in 2018 to align the Carer's Allowance (currently £69.70 per week (2022-23) and aligned with the Department for Work and Pensions) with Jobseeker's Allowance (see Welfare Benefits for more detail).

The Carer's Allowance Supplement is £245.70 (2022).³³ In February 2022, 81,059 people were eligible for the Carer's Allowance Supplement.³⁴ Scotland has also developed a Young Carer Grant which delivers an additional payment of £300 yearly to carers aged 16-18, which can be spent as the carer chooses. In 2022, Scotland consulted on plans to introduce Scottish Carer’s Assistance to replace the Carer's Allowance as part of its wider work to devolve benefits.³⁵

Scotland also operates a Short Breaks Fund which provides grants to third-sector organisations that support unpaid carers in taking breaks from their caring role.³⁶  The Scottish government has allocated an extra £5 million for short breaks in the 2022/23 budget, on top of the annual £3 million voluntary sector Short Breaks Fund.³⁷

Northern Ireland

The Carer’s Support and Needs Assessment³⁸ is a component of the Northern Ireland Single Assessment Tool (NISAT), but it can also be used as a standalone component of care.³⁹ Carers deemed eligible under the NISAT are entitled to a self-directed support plan. As with assessment for service users, the health and social care trust retains the right to determine whether an individual is eligible under the assessment.⁴⁰ Although benefits are devolved to the Department for Communities, carers are entitled to a Carer's Allowance of £69.70 per week (2022/23), identical to the other UK countries and under the same eligibility criteria.⁴¹

It has been argued that legislation surrounding carers in Northern Ireland is outdated⁴², with the most recent legislation, the Carers and Direct Payments Act, dating back to 2002. This provides no legislated definition of a carer. More recent policy papers, such as Transforming your care in 2013, have recognised the need for carers to be included in strategic implementation plans and to have an increased uptake of the carer's assessment. Power to people in 2017 included specific proposals for reform of carer support, with an alignment with the English Care Act as a minimum.

Stakeholders reported a very strong tradition of caring in Northern Ireland, with the majority being women⁴³, although this is felt to be changing. The heavy reliance on informal carers suggests this move away from traditional caring responsibilities could have impact on the sustainability of the social care system. As with the other countries of the UK, concerns were raised about the health and wellbeing of carers, along with financial hardship.⁴⁴

In 2020, a new ID card was launched to improve recognition and support of carers in Northern Ireland.⁴⁵ These give carers greater access to food, medicine and other supplied that they need to support the person they care for.

In April 2021, the Support for Carers Fund was announced, totalling £4.4 million.⁴⁶ Additional grants have been announced in grants since, including a further £1 million in March 2022⁴⁷ and an additional £900,000 in August 2022.⁴⁸