WF 32

Ymchwiliad i gynaliadwyedd y gweithlu iechyd a gofal cymdeithasol

Inquiry into the sustainability of the health and social care workforce

Ymateb gan: Ymddiriedolaeth Gofalwyr Cymru

Response from: Carers Trust Wales


Health, Social Care and Sport Committee

Inquiry into the sustainability of the health and social care workforce


Your name:   Kieron Rees


Organisation (if applicable): Carers Trust Wales


email / telephone number: XXXXXXXXXXXX / XXXXXXXXX


Your address: Carers Trust Wales, 3rd Floor, 33 Cathedral Road, Cardiff, CF11 9HB














About Carers Trust Wales

Carers Trust Wales is part of Carers Trust, a major charity for, with and about carers. We work to improve support, services and recognition for the 370,000 people in Wales living with the challenges of caring, unpaid, for a family member or friend who is ill, frail, disabled or has mental health or addiction problems.

Our Mission is to identify, support and involve Wales’ unpaid carers through the provision of action, help and advice.

Together with our locally-based network partners, we provide access to desperately-needed breaks, information and advice, education, training and employment opportunities – working with 20,000 carers a year in Wales. Our network partners benefit from the provision of grants, advice documents and reports to improve carers’ services. We give carers and young carers opportunities to speak to someone and make their voices heard, offline via our carers’ services and young carers’ schemes, and via our online communities.

Our Strategic aims are

  1. Championing carers – ensuring their voices heard and carers have a high profile across Wales including in the media, government
  2. Delivering services for carers in Wales – researching and promoting solutions for carers across Wales
  3. Building partnerships and delivering change – working meaningfully across sectors to reach more carers in all spheres of life
  4. A strong Carers Trust Wales network – working closely with our network partners to increase sustainability and impact across Wales

Our Vision is a Caring Wales – where unpaid carers are recognised and able to get the support they need







1.    Carers Trust Wales works with our Network of 15 local services across Wales to support carers. Many of our Network Partners deliver regulated care including replacement care, short breaks and day services. All of our Network Partners are independently constituted charities whose purpose is to support carers.


2.    A carer is anyone who cares, unpaid, for a friend or family member who would not cope without their support.

3.    Wales is a caring country, according to the 2011 census we have the highest proportion of carers in the UK. The 2011 census also found that carers in Wales care for longer on average than carers anywhere else in the UK[1].

4.    Officially, 12% of the population of Wales provide unpaid care to a friend or family member who would not cope without their support. In reality, this figure is likely to be much higher. The care provided by unpaid carers in Wales is the equivalent of £8.1billion worth of care every year[2].

5.    Replacement care and short breaks play a vital role in protecting the well-being of both carers and those they care for. Similarly, there is a large evidence base that supports the economic case for investing in support for carers – doing so reduces demand upon both health and social service[3]. For example:

                                          i.    One study found that when a person is readmitted to hospital, problems associated with the carer were the reason in 62% of cases[4].

                                        ii.    One report found that commissioning for carers could equate to a saving of £4 for every £1 spent[5]

                                       iii.    35% of carers without good support experienced ill health compared to 15% of those with good support

                                       iv.    Fewer carers experience mental health problems if they have taken a break since beginning their caring role[6]

6.    Over the past few years we have seen increasing pressure placed on our Network Partners from funders. This has led to significant difficulties in recruiting and retaining staff across Wales, as well as a wider issue about sustainability of these third sector, quality-focused services.

7.    For example, the rates paid by commissioners are too low to pay staff a reasonable hourly rate, and in some cases too low to cover even the minimum costs associated with providing replacement care. Based on a sample collected from local authorities by the UKHCA in September 2014, the average rate paid by councils in Wales for care was £14.05 an hour[7]. The UKHCA calculates that to adequately cover National Living Wage, backend costs, travel time etc. a minimum of £16.70 is required[8].

8.    Many of the factors that impact upon recruitment and retention amongst our Network Partners are a direct result of the lack of investment in social care by some local authorities. Furthermore, with the introduction of duties including automatic enrolment of pensions and the National Living Wage, the financial pressure on these services continues to increase while funding continues to decline.

9.    Another factor in the recruitment and retention of staff is the working environment. In many cases, rotas and travel times are so tight that staff find that they are under pressure to get from one call to the next – it can be highly demanding and stressful.  Many staff reported in exit interviews that they feel the quality of the care they are able to provide has been impinged on because of the time stress they are under, others that they are providing the services the public need despite the system they work under. 


10. These issues arise from the continuing pressure to do ‘more with less’. This has been the case for a number of years

11. Carers Trust Wales believes that the following are fundamental to tackling the issues faced in recruitment and retention of the social care workforce:

a.    Ensuring that commissioning is considered and adequate, and that it funds services in a sustainable way that fosters a good working environment

b.    Local health boards disproportionately benefit from the work of Wales’ unpaid carers, and so should have a vested interest in ensuring unpaid carers receive the support they need. As such, local health boards should be involved in commissioning and funding social care in Wales.

c.    New models of funding replacement care and breaks for carers should be explored, for example looking at Scotland’s Short Breaks Fund.

12. In the past year, Carers Trust Wales has been calling for the introduction of a national Carer Well-being Fund. The purpose of the fund would be to increase the availability of breaks to carers across Wales, easing pressure on health and social services and supporting the delivery of adequately funded social care in Wales.


13. Such a fund would take into account the lessons of Scotland’s Short Breaks Fund which has delivered over £11 million worth of breaks to carers in Scotland since 2010[9].

14. A modest annual investment of £1.4 million in Wales would deliver around 53,000 hours of care at home at the new National Living Wage or provide 31,000 days of care at day centres across Wales. Alternatively, the same fund would secure 2,040 weeks of respite. These calculations include the cost of administrating the fund and are based on UKHCA calculations on the true cost of delivering care[10].

15. Carers Trust Wales strongly believes that without action to remedy the current counter-productive funding and commissioning environment for replacement care and breaks for carers, not only will the issues described in this response worsen, but we risk seeing the loss of high-quality, not-for-profit services that have the needs of unpaid carers at the heart of everything they do.




Kieron Rees

Policy and Public Affairs Manager, Carers Trust Wales






[3] Much of the evidence is collated in our publication ‘Investing in Carers, Investing to Save’ (2016),

[4] Williams, E, Fitton, F (1991) ‘Survey of Carers of Elderly Patients Discharged from Hospital’, British Journal of General Practice, 41, 105–108.

[5] Conochie, G (2011), Supporting Carers: The Case for Change (The Princess Royal Trust for Carers and Crossroads Care).

[6] Singleton, N, Maung, NA, Cowie, A, Sparks, J, Bumpstead, R, Meltzer, H (2002) Mental Health of Carers (Office of National Statistics, The Stationery Office).




[10] Full proposal is available upon request