Two unpaid carer cohorts were identified in three geographical areas (Neath Port Talbot, Swansea and Denbighshire) using two routine data sources:
(1) Local Authority (LA) identified: people who received a carer assessment, as recorded within the local authority data.
(2) Primary care general practice (GP) identified: people who were recorded as providing unpaid care within primary care data.
The study period for each geographical area was determined by the period for which local authority carers’ assessment data was available (Figure 1).
The number of GP-identified unpaid carers increased during quarter four (October – December) of each year, and there was a dramatic increase in quarter one (January – March) of 2021 (Figure 1).
This 2021 increase aligns with the publication of the Vaccination Strategy for Wales (14) and COVID-19 vaccination of unpaid carers (15).
Identification using carers’ assessment data likely remained relatively stable over time due to local authorities already conducting carers’ assessments at full capacity. In contrast, GPs can see large numbers of patients in shorter amounts of time, allowing for a larger capacity to record people as unpaid carers in primary care data. This allows fluctuation in the numbers of GP-identified unpaid carers over time in response to external factors (e.g. pandemic, winter pressures etc.). It is also important to note that the use of primary care codes (Read codes) is subjective and varies between situations and GPs.
The majority of unpaid carers were recorded in GP records, ranging from 69.7% to 79.6% depending on the geographical area. Fewer than 4.0% of the identified unpaid carers in each area were recorded in both carers’ assessment and primary care data within the study period.
As both data sources are intended for different administrative purposes, the lack of overlap may be due to differences in support needed by individuals or how data is being recorded. It is also unknown how many of those recorded as unpaid carers within primary care data are on the waiting list for a carer assessment – only using completed assessment data may increase the disparity between populations. Looking from April 2021 to March 2022, identified unpaid carers comprised less than 1.0% of the adult population in each geographical area (16). In comparison, between 13.2%-15.4% of the population in these areas reported providing unpaid care in the 2021 census (17).
Using local authority and primary care data sources, we were only able to determine a small proportion of unpaid carers in each local area. This suggests that only using a single data source would limit the understanding to a specific group of unpaid carers.
(14) Government W. Vaccination saves lives Mae Brechu yn achub bywydau Vaccination Strategy for Wales. 2021; Available from: gov.wales
(15) Welsh Parliament Senedd Research. Research Briefing. 2022 [cited 2022 Aug 30]. p. 1–34 Coronavirus timeline: the response in Wales. Available from: research.senedd.wales
(16) Estimates of the population for the UK, England, Wales, Scotland and Northern Ireland - Office for National Statistics [Internet]. [cited 2023 Aug 17]. Available from: ons.gov.uk
(17) Unpaid care, England and Wales - Office for National Statistics [Internet]. [cited 2023 Aug 17]. Available from: ons.gov.uk