This guideline covers support for adults (aged 18 and over) who provide unpaid care for anyone aged 16 or over with health or social care needs. It aims to improve the lives of carers by helping health and social care practitioners identify people who are caring for someone and give them the right information and support. It covers carers’ assessments, practical, emotional and social support and training, and support for carers providing end of life care.


The 2011 Census indicated that there were around 6.5 million unpaid carers in the UK, with 1.3 million being over 65. Most carers were aged between 50 and 64 but people aged 65 and over made up a higher proportion of carers (19%) than in the population as a whole.

Carers UK (2015) estimated that the number of carers will increase to 9 million by 2037. This rise is linked with a number of factors, not least the increasing number of people aged over 85 (the group most likely to need care and support), which is expected to increase to 1.9 million by 2020 (Office for National Statistics). Other pressures include the continued closure of care and nursing homes and the increased use of care at home (The state of health care and adult social care in England 2018/19, Care Quality Commission). In addition, according to a survey conducted by Dying Matters, 70% of people expressed a wish to stay in their own home, and to die at home rather than in hospital or a nursing home. This is likely to further increase reliance on family members and friends.

Despite the recognised pressures, both Carers UK's State of caring report 2019 and the Government response to the 2016 carers call for evidence (in advance of the Carers action plan 2018 to 2020) report clear evidence that many carers did not feel adequately supported and that although caring can be immensely rewarding, many found that they did not feel respected, valued and supported for the contribution they made. Guidelines on supporting carers are therefore urgently needed.

The purpose of this guideline

This guideline provides action-orientated recommendations for good practice, aimed at improving outcomes for adult carers. The guideline is based on the best available evidence of effectiveness, including cost effectiveness, as well as evidence on the views and experiences of carers, people using services and practitioners. It identifies good practice in providing support that enhances the wellbeing, resilience and life experience of adult carers.

The guideline covers information and support for carers; identifying carers and assessing their needs; helping carers stay in, enter or return to employment and training; providing community support, training, psychological and emotional support for carers; and providing support during changes to the caring role and during the end of life period of the cared-for person.

Most carers will need support from a number of different services, including the NHS. The NHS long term plan emphasises the vital contribution of carers and the need for more integrated and personalised support (including greater use of personal health budgets). The Care Act 2014 expects the NHS and social care to work together and where possible to integrate services and support.

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