Impact of having a carer on health and social care use

Key statistics

• adults with a registered carer had 27% higher combined health and social care costs than those without a carer
• social care accounted for 39% of the cost difference between people with and without carers.

Key messages

• having a carer is associated with higher use of health and social care services across all settings
• carers often act as advocates, supporting access rather than substituting formal care
• assumptions that carers reduce demand on services are challenged by the findings
• people without carers may face barriers to accessing services, raising equity concerns
• the study highlights variation in carer roles, though available data could not fully differentiate these differences.

Policy implications

• policies that assume carers reduce reliance on formal care may need to be reconsidered
• carers could be more effectively supported through training and inclusion within formal care systems
• services may need to identify and support people without carers who are at risk of unmet need
• care coordination and navigation support could help address access gaps.

Gaps

• limited differentiation between types and intensity of caring roles
• reliance on primary care records to identify carers may undercount caring relationships
• lack of longitudinal analysis to assess longer-term impacts on service use and outcomes.

Commentary
This study challenges common assumptions about the role of informal (unpaid) carers in health and social care systems. Rather than reducing service use, the presence of a carer is associated with higher costs and increased access across care settings, particularly within social care.

The findings suggest that carers play an enabling role, acting as advocates and coordinators who help individuals navigate complex systems and access support. In this sense, carers often address unmet needs rather than replacing professional care.

From a care equity perspective, the study raises concerns about individuals without carers. Lower service use among this group may reflect barriers to access rather than lower need, pointing to potential inequities in how support is reached and received.

The evidence highlights the need for policy approaches that recognise carers as part of the wider care system while also addressing gaps for people without informal support. Better integration, support and identification of caring relationships may help reduce inequities in access, experience and outcomes.