Unpaid carers still ‘not recognised as equal partners in care’, new report warns

The report, Not on the Radar, highlights a continuing disconnect between how professionals and carers view collaboration. While most of the 109 practitioners surveyed said they believed they worked well with unpaid carers, the 371 carers who took part offered a strikingly different account, describing exclusion from decisions, lack of recognition, and a growing sense of exhaustion and invisibility.

The Commission said the findings point to a “persistent gap” between the principles underpinning Scotland’s national carers’ strategy and what happens in practice.

“Unpaid carers contribute so much, but far too often at a cost to themselves,” said Claire Lamza, Executive Director (Nursing) at the Mental Welfare Commission. “Our report shows a clear and persistent gap between the aim of including carers and what actually happens day to day.

“The Care Reform (Scotland) Act 2025 must be used to create a clear legal duty for services to involve carers at every stage. This is essential to turn good intentions into real change for the carers supporting their loved ones.”

Carers described significant personal sacrifices, including loss of income, declining health, social isolation and difficulties accessing their own medical care.

One respondent said: “Being an unpaid carer has affected every aspect of my life. I have never just been able to be in the role of ‘mum’.”

The Commission warns that the long-standing reliance on unpaid carers, estimated to provide care worth billions to Scotland’s economy, is deepening as services face mounting financial and workforce pressures. With community support stretched and eligibility thresholds rising, unpaid carers are increasingly filling gaps in provision, often without adequate professional support.

Social work professionals responding to the survey tended to rate their relationships with carers more positively than carers themselves, suggesting that efforts to embed co-production and partnership are not yet translating into everyday practice.

The report also draws attention to the lack of representation from young carers. Only three young people responded to the survey — a figure the Commission described as “worrying and revealing.”

The findings echo wider concerns raised by local authorities and third-sector organisations about identifying and supporting young carers, particularly those balancing school or employment with caring responsibilities.

The Commission is calling on the Scottish Government to use the Care Reform (Scotland) Act 2025, which came into force in June and is now in its implementation phase, to embed a clear legal duty on services to treat carers as equal partners in care.

While Scottish legislation, including the Carers (Scotland) Act 2016, already requires local authorities to prepare adult carer support plans and involve carers in decisions, the new report argues that these duties are inconsistently applied and not always enforced.

The Commission’s recommendation would strengthen the statutory obligation for integration authorities and care providers to evidence carer involvement in assessments, planning, and review processes, a move likely to have implications for social work practice, care governance and workforce training.

For local authority and health and social care partnership staff, the report reinforces the need to review how carers are engaged during case planning, multidisciplinary meetings and service design.

Practitioners may also need clearer guidance on balancing confidentiality and consent with carers’ rights to be informed and involved.

The Commission said it will continue to monitor how the Care Reform Act is implemented, with a focus on ensuring carers’ voices are “embedded, not just acknowledged.”