Unpaid carers are the single largest provider of care to people with support needs in our communities, and they save the NHS and social services millions of pounds a year. One estimate puts the value of unpaid care in the UK at £132 billion per year – almost twice what it was in 2001, and close to the annual UK health spend [i].
In recent decades the number and proportion of people born with disabilities and surviving into adulthood and later life has increased significantly. Improvements in health care and general health also mean more people are surviving serious illnesses like cancer or stroke. The increase in the number of people living with long-term conditions creates new and more complex demands on our health and social care services which are under pressure from already stretched NHS and social care budgets. Unpaid care provided by family, friends and neighbours is increasingly helping to meet growing demand and plugging gaps in services.
However, the UK’s rapidly ageing population structure and longer life expectancies mean that the numbers of those in need of care and support is beginning to exceed the numbers of working age family members able to provide it. The high proportion of elderly residents in the area has led to the two counties having some of the highest dependency ratios in Wales. Conwy CB in particular has a dependency ratio that is one of the highest in the UK, comparable only to seaside retirement areas such as those found on the south coast of England. Though a dependency ratio is not a direct measure of care need or provision (it is mainly an economic measure), it can, when coupled with information about the age structure of our population, be a useful indicator of the requirement for unpaid care amongst older age groups.
Caring for someone else can be demanding, and can lead to physical health problems for carers themselves (from physical exertion such as lifting or carrying, and from general fatigue). Carers can also be faced with pressures on their mental health such as dealing with stress and worry about the person being cared for and the impact of their illness; social isolation and lack time to focus on themselves; money worries due to reduced household income and/or increasing care costs; and feelings of frustration and anger with the person they are caring for and with the situation they find themselves in.
According to the 2011 Census, over 13,600 people in Conwy County Borough (11.8% of the County’s population) and over 11,600 people in Denbighshire (12.4% of the County’s population) provide unpaid care. Almost 30% of these carers (nearly 4,000 people in Conwy CB and 3,400 in Denbighshire) provide 50 or more hours of care a week. Such high levels of unpaid care provision will have a huge impact on the economic and social well-being of the carers as well as those being cared for. There will also be a toll on both carers’ physical and mental health. Those providing over 50 hours of care each week are twice as likely to be in bad health as non-carers [ii]. About two thirds of all unpaid carers are aged 50 or over – in Conwy CB 30% are aged 65+; 27% in Denbighshire.
A young carer is someone under 18 who helps look after someone in their family, or a friend, who is ill, disabled or misuses drugs or alcohol. Young carers may be ‘hidden’, that is, not known to agencies or receiving family support. Since 2016 greater identification of young carers, increased awareness and understanding of their needs and the introduction of bespoke models of support and carer champions in schools [iii] has resulted from pilots undertaken by Carers Trust Wales (which included 2 schools in Denbighshire and 1 in Conwy) and other organisations supporting young carers in North Wales (engagement with 33 schools including 6 in Denbighshire and 4 in Conwy).
The number and proportion of people providing unpaid care has increased since the 2001 Census – an increase of about 1,350 in Conwy CB and 950 in Denbighshire. More than half of that increase (56% of the overall increase in Conwy CB and 65% in Denbighshire) has been in people providing 50+ hours of unpaid care a week.
The increase has been mainly in the number of people aged 65+ who provide unpaid care, which increased by over 1,050 in Conwy CB and over 850 in Denbighshire. This was an increase from 12.6% to 14.4% of all people aged 65+ in Conwy CB and from 12.9% to 15.9% in Denbighshire.
Provision of unpaid care 2001 and 2011
Source: 2001 & 2011 census of population, Office for National Statistics
It is difficult to make a reasonable prediction about future provision of unpaid care, as it is influenced by a complex interaction of factors such as changes in social care provision, long term trends in health and well-being, housing policy, and friendship and family networks. However, a straightforward application of current rates to predicted future populations suggest that by 2035 the numbers of people providing 50+ hours of unpaid care could increase to about 4,300 in Conwy CB and 3,950 in Denbighshire – a percentage increase since 2011 of about 8.4% in Conwy CB and 16.4% in Denbighshire.
The number of people aged 65+ providing unpaid care is expected to rise by about 1,400 in both Conwy CB and Denbighshire – a percentage increase since 2011 of about 35.3% in Conwy CB and 45.0% in Denbighshire. An increasing reliance on older carers – who may have age related well-being needs of their own – could be precarious. [i]. National population and health condition trends indicate that the greater volume of carers are likely to be caring for older people, and particularly older people with dementia.
These predictions have significant implications for the public sector in Conwy and Denbighshire. Supporting carers by providing respite care and other services is a key priority for helping people maintain their independence in their own home and reducing the longer term burden on the NHS and council services.