Palliative and end of life care are increasingly in demand as people are living longer and with multiple long-term conditions. However, an estimated 100,000 people in the UK that could benefit from palliative care die without receiving it each year. There is substantial evidence that inequalities in access to palliative and end of life care relate to various sociodemographic factors. Experts have highlighted that access to palliative and end of life care may improve quality of life for patient and family and reduce symptom burden. This POSTnote summarises the key components of palliative and end of life care and recent changes in UK policy. It identifies inequalities and challenges to accessible provision. It also reviews evidence on the impact of the COVID-19 pandemic on the provision of care and outlines key trends.
Documents to download
Unpaid Care (559 KB , PDF)
The Government defines unpaid care as a private arrangement whereby someone cares for a family member, friend, or neighbour because of long-term physical or mental ill health or disability, or care needs relating to old age. Carers provide a range of support including personal care, emotional support, help with practical tasks such as shopping, and reminding or giving medication. Most unpaid care is provided by children and spouses.
Positive effects of caring including improvements in psychological well-being, personal fulfilment and physical health. However, in general, research shows that providing unpaid care is associated with negative impacts on carers’ education, employment, household finances, health and wellbeing, and personal and social relationships. These effects vary according to the characteristics of the carer, the relationship between the carer and the person they care for, and the type, amount (number of hours per week), and duration (length of time caring) of care provided. For example, effects tend to worsen for carers that provide personal care (such as helping to dress), care for 50 or more hours of care per week, and for those that live with the person for which they care.
Support for carers can be provided by governments (through the benefits system for example), employers, health and social care services, charities, schools, friends and family, or paid for privately. Across the UK, local authorities have a duty to identify carers and carers have the right to request an assessment of their support needs. Types of support can include financial, employment, respite care, training, and emotional support. Some carers, such as those from ethnic minorities, can find it difficult to access support.
There have been few evaluations of financial and employment support for carers but evidence suggests that paid services for the person cared, such as home care, may be effective in supporting carers’ employment. Providing carers with respite care may increase wellbeing and reduce stress, and education and training may help to increase carers’ understanding of health conditions.
- Around 6.5 million carers in the UK provide care worth an estimated £57 billion to £100 billion per year. The number varies across the UK with a higher proportion of carers in Wales and Northern Ireland.
- Providing unpaid care can affect carers’ education, employment, relationships, household finances, health and well-being. Effects on carers tend to worsen with the more care provided.
- Support for carers can be provided by a range of organisations, such as employers and governments, and it can include financial, employment-related, respite care, and emotional and social support. Some carers, such as those from ethnic minorities, can find it difficult to access support.
- Respite breaks, training, and counselling can improve carers’ mental health and reduce stress.
POSTnotes are based on literature reviews and interviews with a range of stakeholders and are externally peer reviewed. POST would like to thank interviewees and peer reviewers for kindly giving up their time during the preparation of this briefing, including:
- Age UK*
- Carers UK*
- Department of Health and Social Care*
- Dr Anne McMunn, University College London
- Dr Athina Vlachantoni, University of Southampton*
- Dr Elizabeth Webb, University of Southampton
- Dr Ewan Carr, King’s College London*
- Dr Kate Baxter, University of York*
- Dr Konstantina Vasileiou, University of Bath
- Dr Linda Pickard, London School of Economics*
- Dr Lisa Buckner, University of Leeds*
- Dr Rebecca Lacey, University College London
- Dr Sally Wilson, Institute for Employment Studies
- Dr Ursula Henz, London School of Economics*
- Elizabeth Lemmon, University of Stirling*
- Local Government Association*
- New Policy Institute (NPI)
- Nicola Best, Northamptonshire Carers
- Northamptonshire Healthcare, NHS Foundation Trust
- Northern Ireland Assembly Research and Information Service*
- Professor Fiona Carmichael, University of Birmingham*
- Professor Gillian Parker, University of York
- Professor Jo Aldridge, Loughborough University*
- Professor Jyoti Choudrie, University of Hertfordshire
- Professor Sue Yeandle, University of Sheffield
- Public Health England
- Raj Patel, University of Essex
- Rob Davies, University College London
- Scottish Government*
- Welsh Government*
* Denotes external reviewers of the briefing.
Documents to download
Unpaid Care (559 KB , PDF)
Medical advances mean that increasing numbers of people survive physical injury, stroke, periods of low oxygenation and severe brain infections. Some, however, are left with substantially reduced consciousness. This paper discusses the medical, ethical and commissioning challenges associated with the care of patients in vegetative and minimally conscious states, and explains the impact of recent legal judgments.
Research suggests that the threat from invasive non-native species (INNS) is growing. Biological invasions by INNS harm native species and habitats and can have economic impacts. Biosecurity measures can be adopted to prevent the introduction and spread of INNS. This POSTnote summarises the drivers and impacts of INNS and the measures needed to meet national and international environmental targets.