The impact of caring on peoples’ physical and mental health across England remains high and is worse for those from some groups, according to the latest data analysis by Carers UK. [i]

The findings are revealed in the report ‘Carers Health and experiences of primary care, the charity’s examination of unpaid carers’ responses to the 2021 GP Patient Survey. This annual research is commissioned independently by NHS England to identify patient experiences and general health. Of the 850,000 responses, nearly 1 in 5, (18%) have some unpaid caring responsibilities. [ii]

The analysis found that:

• 60% of carers report a long-term health condition or disability compared to 50% of non-carers
• 70% of lesbian, gay, or bisexual carers report a long-term condition compared to 60% of straight carers [iii]
• Carers from some backgrounds were less likely to say the healthcare professional they saw recognised and understood any mental health needs they had. Whilst 86% of white carers said they felt they did, this dropped to 78% of black carers and 76% of Asian carers.[iv]
• 36% of lesbian, gay, or bisexual carers have a mental health condition compared with 13% of heterosexual carers – nearly treble the rate

The findings build on the charity’s ongoing work to understand the adverse impact of the pandemic on unpaid carers. [v]

At the height of the pandemic, Carers UK estimates that there were 13.6 million unpaid carers across the UK.[vi] As health and social care services closed and the need to care for family members, partners and close friends with disabilities and ill-health at home increased, millions more became unpaid carers overnight. Many services are yet to re-open. The charity’s Covid-19-specific research identified that almost three-quarters (72%) of carers have had no breaks at all since the first UK lockdown and 74% have said they are exhausted, as a result of caring.

Carers’ health is known to be worse than that of non-carers due to the pressures of the role and is compounded by many factors, including providing more than 50 hours of care each week. Caring has been announced as being a social determinant of health recently by Public Health England.

Of the 60% of carers who had a long-term condition, disability, or illness, almost two-thirds (64%) reported that their condition reduces their ability to carry out day-to-day activities. This shows that carers’ health and wellbeing is poorer than others and potentially affects their ability to care.

Lesbian, gay, and bisexual carers were most likely to report a long-term health condition or disability; and of this group, Three-quarters (75%) stated that it affected their day-to-day life, in contrast to 62% of straight carers.

Half (51%) of carers said they had avoided making a GP appointment in 2021 compared to 40% of non-carers. This rose to 61% of Asian carers and those from mixed ethnic backgrounds.

Matthew McKenzie, Co-Chair of the Black, Asian and Minority Ethnic Carers Forum said:

“This is a welcome, yet worrying, snapshot of the last year during such a stressful time for carers. That carers from some minority ethnic backgrounds are less likely to feel mental health concerns are understood by their GP, with some less likely to even make a doctor’s appointment, is evidence that better recognition and understanding is needed. It is clear carers from particular groups can face barriers to getting the support they need.”

Feeling lonely or isolated is a common experience for carers, as a direct result of their caring role. The impact of isolation on health is wide-reaching, including increased risks of death, cognitive decline, dementia, coronary heart disease and stroke.[vii]

The percentage of carers responding to the GP survey who said they felt isolated doubled from 2020-2021 from 9 to 18% and there was a sharp difference between some groups with 35% of lesbian, gay, and bisexual carers saying they have felt isolated in the last year compared with 17% of heterosexual carers. In terms of ethnicity, carers with a mixed ethnic background were more likely to report feeling isolated compared to other ethnic groups.

Dave Williams, Co-Chair of the LGBTQ+ Carers Expert Advisory Group commented: 

“This report makes for sober reading. It is clear the demands of caring significantly impact on carers’ physical, emotional, and mental health and the support carers need is sadly lacking.

“For carers in the LGBTQ community, isolation is further amplified as family members can and often do perceive that a non-heterosexual relationship implies a greater degree of availability to undertake a caring role.  For some LGBTQ carers, the demand to become a carer can mean a return to family environments and the loss of the support of their social network in their community of identity. There is a significant lack of awareness and understanding of the impact of this in terms of social isolation.”

Helen Walker, Chief Executive of Carers UK said:

“Our analysis shows the impact of caring on carers’ long-term health and wellbeing. Throughout the pandemic many have had no choice but to take on more hours of care as they continue to experience reduced support. This is having an impact on their physical and mental health, with the number of those caring feeling isolated doubling in the last year.

“Some carers are being even more impacted by the pressure of their role than others. Understanding how health inequalities affect carers and those from particular groups will be key to ensuring an equal recovery from the effects of the pandemic.

“The NHS depends heavily on carers. Pre-pandemic, carers saved the economy £132 billion a year. During the pandemic, this rose to £193 billion, more than is spent each year on the NHS in England. The increase in the number of people caring and pressures on services, together with funding shortages, means it’s more important than ever that we seek to identify carers and support their health and wellbeing.”

Carers UK is calling for:

• GP practices to identify carers quickly and makes services available, as soon as possible.

Carers are still not routinely identified or supported by health and social care professionals and many are not aware of support available to help them look after their own health and wellbeing. GP practices need to be supported to speed up their identification of carers as early as possible.

• The government to introduce a duty on the NHS to have regard to carers and promote their health and wellbeing.

This would help bring a more systematic approach to carers’ health.

• The GP survey to continue and include caring as a specific question.

This is a key tool to improve knowledge and understanding of the health inequalities among marginalised groups.

The full report can be found here.

[i] The survey results were analysed using NHS England’s GP Patient Survey analysis tool and carers were defined as those who had answered “Yes” to Q56 regardless of the number of hours per week they had selected. “Do you look after, or give any help or support to, family members, friends neighbours or others because of either: long-term physical or mental ill health / disability, or problems related to old age?”

[ii] The GP Patient Survey is an independent survey run on behalf of NHS England which asks questions about people’s experiences of their GP practice and their general health. By looking specifically at the data for carers, we learnt more about their experiences of healthcare over the pandemic and how caring may be impacting people’s health and wellbeing.

[iii] Lesbian, gay and bi-sexual carers – the GP Patient Survey nationally does not enable any further analysis of any other groups of carers.

[iv] The ethnic breakdown of respondents is derived from the GP patient survey data, and it is not possible to disaggregate the groups any further than we have done so here.

[v] We will be conducting more research with both lesbian, gay and bisexual carers and Black, Asian and Minority Ethnic carers throughout our Making Carers Count project.

[vi] Carers UK 2020 ‘Unseen & Undervalued: The value of unpaid care provided to date during the Covid 19 Pandemic.’

[vii] The Campaign to End Loneliness (no date) ‘The Facts on Loneliness.’