Overcoming Barriers Unpaid Care and Employment in England Findings from the Scoping Study

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School for Social Care Research 14 May 2012 Overcoming Barriers Unpaid Care and Employment in England Findings from the Scoping Study Linda Pickard, Derek King, Martin Knapp and Margaret Perkins Personal Social Services Research Unit (PSSRU) London School of Economics and Political Science (LSE) A project funded by the School for Social Care Research

Overcoming Barriers: Unpaid Care & Employment People face difficulties in combining paid work and unpaid care Overcoming Barriers study has a distinctive approach Focus is on helping working carers to remain in employment Focus is also on provision of social care support for the person cared-for as a means of supporting carers Research has dual focus on carer & cared-for (Twigg 1996) Emphasis is on support for the cared-for person that enables working carers to remain in employment, and economic impact of providing it

Outline of presentation Background Findings from the scoping study Gaps in evidence Follow-on study on unpaid care and employment

Unpaid care and employment: Background Unpaid care and employment is a key policy issue Carers Strategy (2010) It is crucial that we place a much higher priority on supporting people of working age with caring responsibilities to remain in work, if they wish to do so Emphasis so far has been on flexible working conditions But there is now also an emphasis on replacement care for the cared-for person Carers Strategy (2010) emphasises developing social care markets partly to meet carers needs for replacement care to enable them to continue to work

Background: policy context Law Commission (2010, 2011) local authorities are already required to provide some services to meet needs of carers under certain circumstances, one of which is when a carer s employment is at risk Department of Health (2010) has amended statutory guidance on eligibility criteria in England local authorities are likely to be required to provide services for cared-for person if carer s employment is at risk Carers UK has published new report Growing the Care Market calling for a growth in services to support older people and people with disabilities (Carers UK 2012)

Findings from the scoping study Our scoping study identified several strands of evidence to support a policy emphasis on social care support for the cared-for person ( replacement care) as a means of supporting carers in employment Next slides present some of our evidence around replacement care Five key findings from scoping study

Findings (1) Policy should focus on provision of formal care as a means of supporting working carers Literature review undertaken for scoping study There is negative relationship between unpaid care and employment but uncertainty over direction of causation Provision of unpaid care for 20 or more hours a week or on co-resident basis negatively affects employment status (Carmichael et al 2010, Heitmueller 2007) Policy implication is that, since caring keeps people from working, policy should focus on the provision of formal care (Heitmueller 2007: 537)

Findings (2) Service receipt by working carers is low Only very small percentage of working carers have access to publicly-funded services in England Services are likely to be accessed through carers assessments According to 2009/10 Survey of Carers in Household in England, only 4% of carers working full-time and 6% working part-time are currently offered an assessment or review Moreover, when carers do receive an assessment most are not asked if they wish to do paid work

Findings (3) Many carers currently leave employment Potentially due to lack of support, many working carers currently leave employment We estimate that approximately 315,000 carers aged 16 to 64 in England have left employment to provide unpaid care and are currently out of employment Of these, 120,000 are men and 195,000 are women Figures are based on 2009/10 Survey of Carers in Households in England and 2010 Office for National Statistics (ONS) population estimates

Findings (4) Thresholds at which carers leave work are lower than previously thought Previous studies have shown that care provided for 20 or more hours a week has a significant impact on employment (Carmichael et al 2010, Heitmueller 2007) In our study, a key threshold at which carers aged 50 and over are at risk of losing their employment can occur when care is provided for only 10 or more hours a week Analysis uses English Longitudinal Study of Ageing and examines carers employment status over time

Employment rates two years later of carers who provide care for 10 or more hours a week, continuing non-carers and new carers, by gender, England, 2002/3 2008/9

Findings (5) Public expenditure costs of carers leaving employment are substantial One element of costs to state of carers leaving employment is cost of welfare benefits 2009/10 Survey of Carers in Households shows that over a third of carers who have left employment to care are in households where Carers Allowance is claimed This suggests that around 115,000 carers who have left work to care are claiming Carers Allowance Cost of this benefit for carers leaving labour market is around 0.3 billion a year Conservative figure - excludes costs of other benefits e.g. Income Support and Housing Benefit

Public expenditure costs of carers leaving employment are substantial We also estimate that lost tax revenues of carers leaving employment are around 1.0 billion a year Based on foregone income and average percentage of income that goes on tax of 17.8% Assumes median weekly full-time earnings of 538 for men and 439 for women, and part-time earnings of 142 for men and 157 for women (ONS 2010) Also assumes, based on 2009/10 Carers Survey, that full-time employment rate is same for carers leaving employment as for carers currently in employment (82% of men, 39% of women) Conservative figure - excludes lost NI contributions

Public expenditure costs of carers leaving employment - policy implications In total, public expenditure costs of carers leaving employment are estimated at 1.3 billion a year If there was greater public investment in social care, such as replacement care to support carers, and fewer carers left employment, public spending on benefits would be lower and revenues from taxation would be higher 1.3 billion a year represents a substantial sum in terms of public funding for social care Public expenditure on adult social care is around 14.4 billion a year in England (Dilnot Commission 2011) 1.3 billion represents 9 per cent of current public spending on adult social care in England

Gaps in evidence (1) Is replacement care effective in supporting carers in employment? Despite increasing policy emphasis on replacement care, and evidence to support it, scoping study has not found any peer-reviewed papers on effectiveness of services for cared-for person as means of supporting carers in employment in England There is international literature on this issue, primarily from US and Europe (Lilly et al. 2007, Lundsgaard 2006) However, this literature is inconclusive and not necessarily applicable to England, owing to differences in labour market and community care conditions

Gaps in evidence (2) What are unmet needs for social care support of working carers? Gap in evidence reflects gap in practice Our findings show that carers are at risk of leaving employment when care is provided for only 10 or more hours a week But 2009/10 Personal Social Services Survey of Adult Carers in England shows that the majority of carers known to councils care for 35 or more hours a week Therefore, councils are not in contact with large numbers of carers whose employment is at risk Gap in knowledge about unmet needs for social care support among working carers

Overcoming Barriers: Unpaid Care and Employment - Follow-on Study Scoping study shows there is a need for more evidence to support the development of policies around replacement care for working carers in England Key output of scoping study has been proposal for followon study that aims to fill gaps in evidence Follow-on study has now been funded by NIHR SSCR until April 2014 to look at effectiveness of formal social care in supporting working carers service needs of working carers not in receipt of formal social care support, and costs of meeting them

Outputs from scoping study Project outline available at www.sscr.nihr.ac.uk Blog available at http://blogs.lse.ac.uk/healthandsocialcare/ Findings available soon at www.sscr.nihr.ac.uk Article submitted to peer-reviewed journal Thank you for your attention L.M.Pickard@lse.ac.uk D King@lse.ac.uk M.Knapp@lse.ac.uk M.A.Perkins@lse.ac.uk