Key points

This report presents the results of further analysis of data gathered through the Health and Care Experience (HACE) survey. It provides trend data on how people’s experiences of care services and of providing care have changed between 2015-16 and 2023-24, and reasons for unmet care needs in 2023-24.

The analysis includes results from the latest survey (2023-24) on the number of hours of unpaid care people provided to others, and how they felt about their caring responsibilities. It also presents the results alongside the results from previous years (since 2015-16), to assess how people’s responses have changed over time.

This report also includes the results of new analysis of how people rated any help, care and support with everyday living that they had received, between 2015-16 and 2023-24. Given changes to the wording of the HACE questionnaire over time, it was not previously possible to directly compare results from the latest survey (2023-24) to the results from previous years. Therefore, we have undertaken new analysis of the data, to provide a time series where people’s answers can be directly compared over time. There are more details of this new analysis in the Introduction, and in the Data and methodology sections.

This report also contains results of an alternative and more detailed analysis to Table 3 of the HACE 2023-24 national report, which presented estimates for the reasons why people thought that they weren’t receiving all the care, help or support that they felt they needed.

Experience of help, care and support

The help, care or support respondents are referring to in this section could come from a variety of sources, but it should exclude help received from family and friends.

Analysis of HACE results over time shows that positive sentiment towards experiences of receiving help, care or support has generally decreased from 2015-16 to 2023-24.

For example, among the responses analysed for this new analysis of the HACE data, the percentage of respondents rating the overall help, care or support they received as ‘excellent’ or ‘good’ was similar in 2015-16 (82%) and 2017-18 (82%). But it decreased to 69% in 2019-20 and decreased further in 2021-22 to 62%. In 2023-24 it remained similar to 2021-22 (at 63%).

A very similar pattern is seen in the proportion of people giving positive responses to various person-centred statements about their experiences of care. There were decreases in the proportions of positive responses across all statements between 2017-18 and 2019-20, and again between 2019-20 and 2021-22.

Changes in positive agreement with specific statements were more varied in the most recent year (2023-24), with ratings of some statements further decreasing compared to 2021-22, and others remaining similar. The statements which fewer people agreed with in 2023-24 compared to 2021-22 were ‘I was aware of the help, care and support options available to me’, ‘I had a say in how my help, care or support was provided’, ‘People took account of the things that mattered to me’ and ‘I felt safe’.

Caring responsibilities and hours of care

The proportion of people providing care to others has increased in 2023-24 (16%) compared to 2015-16 (14%). The number of hours of care people provide is also higher in 2023-34 than it was in 2015-16.

The highest total proportion of people saying they provided care was seen in 2021-22, when 18% of people said they provided care.

In 2023-24, 5% of all respondents said they provided 50 or more hours of care per week. This is higher than in the other years analysed for this report (2015-16 to 2021-22), when the proportion was 4%.

Impact of caring and support for carers

Positive sentiment about providing care to others – and feeling supported to do so - has generally been on a downward trend between 2015-16 and 2023-24. For example, the proportion of people agreeing they have a good balance between caring and other things in their life decreased from 68% in 2015-16 to 62% in 2023-24. For some statements, positive ratings have increased in the most recent year compared to 2021-22, although in all cases it remains lower than in 2015-16.

The proportion of positive responses to specific statements did not consistently decrease between 2017-18 and 2021-22, in contrast to agreement with statements relating to experiences of receiving care. This suggests that the experience of people receiving care changed between 2017-18 and 2021-22, but it may have changed in a different way for those providing care.

Unmet need

For the first time in HACE, in 2023-24 people who reported needing help, care or support with everyday living were asked directly about their experience of unmet need. This included both those who reported receiving some form of support but still felt that their needs were not fully met, and those who reported that they were unable to access any support.   

Those who received help and care services for everyday living, or who responded that they didn’t receive help but felt they needed it, were asked:  

‘If you are not receiving all the help and care services for everyday living that you feel you need, which options describe your situation? Please tick all that apply’.  

Among those people who responded, 44% of people who felt that they need more help and care weren’t sure if they were eligible for more, or any, support, 34% did not know how or where to ask for help, and 17% reported they did not qualify for services. (Note these figures are different to the original findings presented in the HACE 2023-24 national report, published in May 2024 – see Introduction for more information).  

Along with the pre-determined options describing possible reasons for needs being unmet, or not fully met, respondents could also include more information in an open text box that accompanied the option “other”. Among these responses, many respondents noted that services can be inaccessible or complex to access, others felt dissatisfaction with the options available to them, some were reluctant to ask for support, and others noted geographical, or transport limitations prevented them from accessing support services. Categories identified from these open text responses are detailed in Annex A.