Where are unpaid carers in this new 'Keep Britain Working' report and discussion (UK)?
I can't find any references to unpaid carers in this labour report, can you?
From a paid worker and part of the economy to an unpaid carer and ‘economically inactive’.1 But even as ‘economically inactive’, it seems Unpaid carers have been omitted from this report. I literally can’t see caregivers within this labour report. Can you?
The report: Keep Britain Working: Final report by Sir Charlie Mayfield. Lead reviewer, Keep Britain Working was published today (November 5th).
The BBC News headline today: ‘Britain sliding ‘into economic crisis’ over £85bn sickness bill, ex-John Lewis boss warns.’
I appreciate how this report opens up more discussions about supporting anyone with disabilities, health issues, and mental health issues to return to work. Some of the initiatives discussed will undoubtedly support unpaid caregivers returning to work IF they can work.2
However, I can’t see any discussion of unpaid carers (the term used for family caregivers in the UK). The focus is on health-related inactivity, and it immediately dives into statistics on types of health issues and conditions, and, unfortunately, the benefits system.
I don’t see the reasons/causes for people leaving the paid workforce to become unpaid carers being addressed.
Why is this an issue?
Because, yet again, it puts economic inactivity —the lack of economic growth and gains — at the door of people who are sick/disabled or tries to flog the old argument that people prefer to claim benefits rather than work.
Without a discussion of unpaid carers, there is also no discussion of
Social care reforms. Sociodemographic trends about the ageing population and increasing costs are well known. MORE people are likely to become economically active to care for their loved ones in the absence of reliable, accessible care that does more than the transactional 15-minute visit.
The impact of the NHS 10-year plan on families and workers, when community care is still fragmented.
The strain on the local health care services, GPs, nurses, district nurses and pharmacies, and their need to coordinate with carers and vice versa to ensure timely, appropriate action and prevention of issues, especially to avoid hospitalisation.
Perhaps, the disconnect is in the data collection? The 2011 Census question mentioned providing unpaid care for family, friends or neighbours, the 2021 question referred to caring for anyone, creating ambiguity.
Some key questions I miss amongst the report:
Where are unpaid caregivers referenced, and are the reasons for their ‘economic inactivity’ documented, addressed with recommendations?
Of those who are ‘economically inactive’, what is the percentage distribution between those leaving to care for sick, disabled, chronically ill family members, versus those who are themselves sick?
Are more people becoming sick long-term because they’re also caring for a loved one?
Excerpt from the Executive summary of the report:
1. Today there are nearly 800,000 or 40% more people of working-age who are economically inactive for health reasons than there were in 2019. The growth in the number who are becoming economically inactive for health reasons is nearly 10 times the growth of the working age population.
2. In the same period there has been a similar increase in the number of people reporting work limiting health conditions – up by over 2 million, an increase of 31%. One in five of all people of working age report having a work limiting health condition. The challenge of tackling economic inactivity is therefore as much within the workplace as it is in the benefits system.
The UK Department of Work and Pensions: Official Statistics. Keep Britain Working 2015 to 2024. Published 19 March 2025
An evidence-based review
The Question: Where are unpaid carers in the discussion of ‘Keep Britain Working’?
The Background (see linked references below)
The increasing need for social care has outpaced economic policies and infrastructure changes (The Government announcement, ADASS, and State of Caring report 2025)
The burden and impact on caregivers are growing (Carers UK and CQC report)
It’s getting worse with a shift from hospital to community care (CQC report)
Unpaid carers who receive Carers Allowance and try to work, risk falling foul of the ‘cliff edge’ earnings Limit (Guardian Newspaper and Carers UK)
The Article:
The BBC Report article. Just published November 5th, 2025: Keep Britain Working: Final report by Sir Charlie Mayfield. Lead reviewer, Keep Britain Working
Quotes the census 2021 data, but as far as I can see, there is no Social Care context in the report. A potential disconnect?
See Page 39 Annex: Labour Market definitions and data. Annex – Exhibit 1
The report focuses on the economic definition of ‘Labour market’. It points to an increase in economic inactivity, and names disability and mental health. Within this diagram, I don’t see unpaid carers represented. Where are those resigning/dropping from the ‘labour market’ to care for family members who are sick, ageing or disabled? Where are the unpaid carers in this labour discussion?
The remaining questions, ‘I can’t see unpaid carers in this information’:
The ‘Back to work’ report does not seem to include unpaid carers in the report. Why is that? (Exhibit 1).
However, the data uses census data, which includes everyone, including carers?
Are people dropping out of the equation and not being addressed by the report, i.e. unpaid carers? Is the overall working population shrinking?
Dear economists and labour force experts, how are labour movements and dynamics accounting for the flux of people who become unpaid carers, but now no longer fit the prescribed ‘labour market definition’ in this report?
Does this definition of ‘labour’ restrict the future potential and thus growth?
I’m not an economist. How and where are unpaid carers included in workforce-potential/growth discussions?
The increasing number of unpaid carers who stop working may be one of the main drivers of economic inactivity. Can addressing the needs of those caring/being cared for be one way to prevent this loss of labour force?
On the other hand, “The economic value of unpaid care is now £184 billion a year roughly equivalent to Government spending on the NHS. However, despite the enormous contribution that carers make to our society, caring often comes at a significant personal cost, especially when adequate support is not available.“ Carers UK State of Caring Report 20253
Are unpaid carers now the default social care infrastructure, in the absence of social care reform, pending the commission’s report?
Recommendation - leverage the existing insights and evidence built by the carer organisations:
For example: Unpaid Carers with Health Needs in the Workplace (Kate Wood, Laurie Dempsey and Beth Neale September 2024) The Carers Trust
References
1. The increasing need for social care has outpaced economic policies and infrastructure changes
The UK government announced January 3, 2025, an independent commission for reforming adult social care, chaired by Louise Casey. Split into two phases, this cross-party commission will report firstly in mid-2026 and then will set out a longer-term plan ‘by 2028’. You can read the response of the County Councils Network here, and Melanie Williams, President of ADASS (Directors of Adult Social Services (UK)) here. Here’s an excerpt:
“Unfortunately, the timescales announced are too long and mean there won’t be tangible changes until 2028. We already know much of the evidence and options on how to reform adult social care, including our independently commissioned Time to Act report, and worry that continuing to tread water until an independent commission concludes will be at the detriment of people’s health and wellbeing. (Melanie Williams)
There is a mountain of evidence and research about the impact of caregiving on the financial, health, and well-being of unpaid carers. State of Caring 2025. The cost of caring – the impact of caring across carers’ lives. By Carers UK. October 2025.
2. The burden and impact on caregivers are growing
Carers UK response: CQC’s annual assessment of the state of health and social care
Press releases 24 October 2025
The Care Quality Commission’s (CQC)4 annual assessment of the state of health and social care in England looks at the quality of care over the past year. This year’s report warns that the health and social care system remains fragmented and under severe strain as it prepares for a major shift from hospital to community care.
Helen Walker, Chief Executive of Carers UK said:
“As our report on the cost of caring, published this week showed, unpaid carers are increasingly providing more care. 52% of carers say the number of hours that they spend caring each week has risen in the last year. This strong message from the Care Quality Commission rightly underlines the real risks of moving care to the community without getting the proper structures, social care and community health funding in place.
“We’re deeply concerned about the potential negative consequences. 74% of carers say they have felt stressed or anxious and 20% have experienced an injury because of caring. Without the right support in place, carers will end up doing even more – leaving them with no choice but to give up work, face financial hardship, experience poor health and face greater isolation than they already do.
“Not only would this be very difficult for families, but it would be challenging for the economy. The Government has already shown that £37 billion is lost to the economy by carers giving up work to care. 61% of working carers say caring has affected the type of employment they have taken on. Our health and social care system relies heavily on the support provided by unpaid carers, and we need to start valuing their contributions.
“Many of these challenges are preventable with better information sharing, integrated services and investment in social care, creating a valuable opportunity to build better support for carers within plans for social care and NHS reform.”
3. …And getting worse with a shift from hospital to community care
CQC warns lack of investment in community services threatens shift towards care outside hospital – and risks ‘erosion’ of care quality
The health and social care system remains fragmented and under severe strain as it prepares for a major shift from hospital to community care, the Care Quality Commission (CQC) has warned in its annual State of Care report.
While there is some encouraging evidence of innovation, community services need significant investment in both capacity and capability to deliver the transformation in people’s care called for in the government’s 10 Year Health Plan for England.
Without more support to help community services deliver the vision of the plan, there is real risk of erosion in care quality, with people struggling to get the care they need and the most vulnerable groups likely to be hit hardest through longer waits, reduced access and poorer outcomes.
The report also highlights longstanding inequalities with some groups of people – including older people, people with dementia, people with a learning disability, and those with complex mental health needs – more likely to struggle to navigate services, often meaning their families and unpaid carers carry increasing burdens.
4. Unpaid carers who receive Carers Allowance and try to work risk may fall foul of the ‘cliff edge’ Earnings Limit
The ‘Cliff-Edge’ Problem The system operates with a severe ‘cliff-edge’ rule: if carers earn £1 over the weekly ‘earnings limit’ (currently £196 as of April 2025, it was £151 from April 2024 to 2025), they must repay their entire benefit.
Ongoing Injustice: Carer’s Allowance Overpayments.5
The Current Crisis: 144,000 carers have fallen foul of strict earnings rules. The system has created a devastating situation where unpaid carers are being pushed into debt and prosecuted for fraud by the DWP over benefit overpayments.
For example, in 2024, Carer’s allowance earnings rules mean a carer who earned £1 more than the £151 weekly threshold for 52 weeks would have to pay back not £52 but £4,258.80 ( the 2024 Carer’s Allowance £81.90/week multiplied by 52)2. Those with overpayment debts over £5,000 also face potential criminal prosecution.
The Earnings Limit is based on income AFTER taxes and pension. In other words, if you are in employment, the following would be deducted from your gross weekly earnings (or gross profit if you’re self-employed) before your earnings are taken into account for Carer’s Allowance:
Income Tax
National Insurance
half of any contributions to your pension
certain business expenses and some alternative care costs3
For example, if you earn £200 a week (after tax and National Insurance have been deducted), you wouldn’t be eligible for Carer’s Allowance. However, if you paid £20 into a pension, half of the £20 could be deducted from your earnings.
Your earnings for Carer’s Allowance would then be: £200 - £10= £190. Being under the earnings limit, this would mean you would meet this condition to claim Carer’s Allowance for that week.
Systemic Failures: The DWP has admitted to checking only 50% of earnings alerts, leading to massive accumulated debts (May 9, 2024). Despite having data-matching technology since 2018, the department has consistently failed to notify carers of potential breaches. This inadequate staffing and monitoring have left many carers unaware of mounting debts until it’s too late.
5. Data definitions: Census 2021, and Carers UK response
Health, demographic and labour market influences on economic inactivity, UK: 2019 to 20226
From the report:
Trends in inactivity, health and age
Only around two out of every three economically inactive persons aged 16 to 64 years with a work-limiting health condition say that long-term sickness or disability is the main reason for their inactivity (although they may say it is a contributory reason). Many respondents state other factors as the main reason for their economic inactivity. For example, 13.1% say they are looking after family or home, and 6.8% describe themselves as retired. Therefore in our analysis, we use data on self-reported health conditions, rather than reason for inactivity, in order to capture the full impact of health on economic inactivity.
Carers UK Press release Jan 2023: Census 2021 data shows increase in substantial unpaid care in England and Wales
152,000 rise in number of carers providing over 50 hours of care to just over 1.5 million.
Over a quarter of a million rise in number of unpaid carers providing 20-49 hours of care.
Surprising overall drop in number of carers from 5.8 to 5 million unpaid carers.
Today the Office for National Statistics has published Census 2021 data about unpaid carers which showed growing intensity of care across England and Wales.
Unpaid carers provide help and support to a relative or friend who has a disability, illness, mental health condition or who needs extra help as they grow older.
There is a distinct increase in the number of people providing substantial care, of 20-49 hours a week (260,000) and 50 hours a week (152,000) between 2011 and 2021 and a deepening of the amount of care provided over time. This is significant because of the devastating impact that substantial unpaid care of over 20 hours per week can have on carers’ health, wellbeing and ability to juggle work and care.
However, despite the pandemic, surprisingly the overall number of unpaid carers has fallen from 5.8 million in the 2011 Census to 5 million in the 2021 Census across England and Wales, mostly through a reduction in the numbers of people providing lower hours of care.
The ONS suggests a number of reasons for this, including changes in the nature of caring during the pandemic and the high levels of deaths during the pandemic. However, it also suggests that the change in question framing could have made a difference. Whilst the 2011 Census question mentioned providing unpaid care for family, friends or neighbours, the 2021 question referred to caring for anyone. This will have had an impact because people don’t recognise themselves as unpaid carers.
6. The new report on November 5th 2025, the rise of economic activity is due to long-term sickness or ill health
More policies and support to help people back to work is essential AND addressing the lack of social care support/reforms
Labour market trends [Click to read the report Page 7 The Landscape Summary]
The UK’s economic inactivity rate has risen since 2019-20, reversing the downward trend of the previous 25 years. The UK appears to be an outlier in this trend compared with G7 and OECD nations.
• The increase in economic inactivity since early 2020 has been driven by an increase in the number of people reporting they are economically inactive due to ill-health and long-term sickness. This is now the most common reasons for economic inactivity.
• Over this period there has been significant growth in people reporting work limiting health condition (both in and out of work). In 2024, there are more people in-work with a work limiting condition than there are economically inactive because of one.
• The growth in these conditions has been driven by increases in mental health conditions particularly amongst the younger cohort (16-34) and musculoskeletal conditions in the older population (50-64).
• Multimorbidity, mental health conditions, disability as well as lower educational attainment and longer periods out of work all increase the risk of being economically inactive for health reasons.
• With no changes, projections estimate this trend to continue, driving up Welfare spending to one of the highest levels across the OECD.
Please ‘❤️’ LIKE the article to raise awareness of this to others
Office of National Statistics A guide to labour market statistics, Census 2021
Economically active: People aged 16 years and over who are either in employment or unemployed. The labour force refers to all economically active individuals.
Economic inactivity: People not in the labour force (also known as economically inactive) are not in employment but do not meet the internationally accepted ILO (International Labour Organization) definition of unemployment because they have not been seeking work within the last four weeks and/or they are unable to start work in the next two weeks.
If anyone’s been trying to find flexible work this is a really great resource that’s been trying to pivot the job search dynamic towards the seeker: Flexa US Job Search or Flexa UK Job Search]
Petrillo, M., Zhang, J. and Bennett, M. (2024). Valuing Carers 2021/22: the value of unpaid care in the UK
The CQC is accountable to the government Department of Health and Social Care, which acts as its sponsor body. While CQC is an independent regulator for health and adult social care in England, the Department of Health and Social Care holds it to account.
The CQC Website About us:
Who we are: CQC is the independent regulator of health and adult social care in England.
Our purpose We regulate health and adult social care, we work together with the public, systems and providers of care to protect people, and to promote and improve the quality of care.
Our vision Everyone receives safe, effective and compassionate care.
Facts were revealed through research and data collected by Carers UK, as well as by Patrick Butler, Social Policy Editor, and Josh Halliday, North of England Editor, of The Guardian newspaper. Guardian journalists win Paul Foot award for carer’s allowance coverage. Patrick Butler and Josh Halliday honoured for their coverage of ‘enraging and heartbreaking’ DWP scandal” (May 20, 2025)
Estimates of the links between work-limiting ill health, demographic and labour market changes, and recent rises in economic inactivity, using Annual Population Survey data.