Cost of unpaid care in England and Wales now exceeds that of NHS budget

The value of unpaid care in England and Wales is now estimated to be £162 billion, exceeding that of the entire NHS budget in England for health service spending, which by comparison was £156 billion for 2020-21.

A carer holding the hand of an elderly woman
  • The value of unpaid care provided in England and Wales now exceeds the entire NHS budget in England
  • At £162 billion a year, the value of unpaid care has risen sharply in the last decade, increasing by 29 per cent since 2011
  • The data highlights how the number of unpaid carers and amount of hours they support a loved one, differs by local authority areas
  • The value of care has increased across all local authorities in England and Wales

The value of unpaid care in England and Wales is now estimated to be £162 billion, exceeding that of the entire NHS budget in England for health service spending, which by comparison was £156 billion for 2020-21.

Following analysis of the latest 2021 Census data, new research from the University of Sheffield and carers’ charity, Carers UK , found that the value of unpaid care has increased by nearly a third since 2011.

Millions of people provide unpaid care for a family member, friend or neighbour affected by long-term illness, disability, or those needing more help and assistance in older age. Most people will experience needing care, or become an unpaid carer during their lifetime.

Often caring around their own commitments such as employment and family life, unpaid carers receive little support or recognition for the massive savings they contribute to the UK’s health and social care system every year.

Professor Matt Bennett, Deputy Director for the ESRC Centre for Care at the University of Sheffield, said: “Without unpaid carers, our health and social care systems would collapse, that is the stark reality of the situation. Despite NHS funding increasing annually, increases to social care funding have not kept pace, so the system is now relying more heavily than ever before on unpaid carers and would collapse without them.

“Our research shows that people are providing more hours of care than ever before, and their contribution to the UK economy now exceeds that of the entire NHS budget in England. There are estimated to be around 5 million unpaid carers in the UK, and it is obvious that they need to be recognised, not just for their contribution to society, but in their need for specific rights and support for the work that they do.”

For the new report, researchers from the Economic and Social Research Council (ESRC) Centre for Care analysed Census data to measure the number of hours people in local authority areas in England and Wales reported caring for a loved one, friend, or neighbour each week. Using information about the current wage rates of carers and nursing assistants, they were able to estimate the monetary value of unpaid care, and how this has changed between 2011 and 2021.

The research found that even though the number of people in England and Wales who identify as an unpaid carer has decreased slightly, an increase in the number of hours of unpaid care is believed to contribute to a staggering increase in the cost of unpaid care in England and Wales.

The report, published by Carers UK today (Wednesday 3 May 2023), sets out 14 recommendations, in a call for government to understand the value of unpaid care and help it make changes to improve the lives of carers in such areas as:

  • Better rights, recognition and support from the NHS and social care
  • Support and rights in employment
  • Freedom from financial hardship, and a recognition of the in poverty and the additional impact and costs of caring
  • Freedom from discrimination and promotion of equality

Dr Maria Petrillo, a Research Associate with the ESRC Centre for Care, said: “The data shows how heavily the health and social care system relies on unpaid carers. About 12,000 people a day become an unpaid carer, and these people are often a lifeline for the most vulnerable in our society.

“Even so, our estimates cannot put a true value on the costs of unpaid care; as it is often done out of love, and immense respect for the person needing support; and can be at cost to carers’ health, careers, social and family lives and even their financial health.

“Our data underpins recommendations that can help the government and local authorities better support unpaid carers, and ensure those who often sacrifice so much for their loved ones, are valued and supported by the health and social care system.”

Professor Matt Bennett, added: “As social care budgets are decentralised, and local authorities decide how to spend their budgets on services, this new localised analysis  illustrates how unpaid care varies and can aid decision making across England and Wales.

“We hope the new report encourages the government to act urgently. It makes clear recommendations that policy makers and local authorities can use to review health and social care service provision across England and Wales and provides an opportunity to improve urgently needed support for unpaid carers.”


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