Integrated Impact Assessments – Carer Strategy

The refreshed Edinburgh Carers Strategy sets out how planning partners will expand carer support, reflecting the Scottish Government’s commitments set out in the Carers (Scotland Act 2016) and subsequent guidance, and reflecting the vision for improved health and social care support, set out  in  the Independent Review of Adult Social Care and in the revised National Carers Strategy 2023-2026.

The 5 key themes and associated national strategic outcomes of the strategy intend to put the individual carer at the centre and focus on five different aspects of unpaid carer support:

  • Living With COVID-19
  • Valuing, Recognising and Supporting Carers
  • Health and Social Care Support
  • Social and financial inclusion
  • Young Carers

The Strategy sets out strategic priorities and commits to strengthening our city-wide and community partnerships, building on the progress made through the implementation plan of Edinburgh Joint Carer Strategy 2019-20223 .  The refreshed strategy also addresses the impacts of Covid and the cost-of-living crisis.

Date Group
26 June 20223 to 11 July 2023 Edinburgh Carers Strategic Partnership Group discussion and wider feedback through member reps
14 June 2023 EIJB Strategic Planning Group
13 December 2022 Edinburgh Integration Joint Board (EIJB)
12 October 2022 EIJB Strategic Planning Group
Ongoing throughout development of the Edinburgh Carer Strategy refresh. The refreshed strategy has been progressed in collaboration with the Edinburgh Carer Strategic Partnership Group (CSPG),

(Membership comprising several commissioned voluntary sector and internal partners, key planning and commissioning colleagues and EIJB Carer representatives).

Ongoing throughout development of the Edinburgh Carer Strategy refresh. Various working groups developed the refreshed strategy and those included Carer representation, EIJB Carer representative, voluntary sector and internal partners and key planning and commissioning colleagues.
Ongoing throughout the development of the Edinburgh Carer Strategy refresh. Views of carers were considered and incorporated by consideration and analysis of local and national surveys, research and consultations.
Ongoing throughout development of the Edinburgh Carer Strategy refresh. Consideration and incorporation of the National Carer Strategy which included extensive carer consultation in its development.
Published March 2023 Consideration of the findings of the Adult Social Work and Social Care Services: City of Edinburgh.

11 July 2023

Name Job Title Date of IIA training
Sarah Bryson Strategic Planning and Commissioning Officer, Health and Social Care (Facilitator and Report writer) Nov 2017
Katie McWilliam Strategic Programme Manager, Health and Social Care
Catherine Corbett Carer Service Development Manager
Luan Sanderson Strategic Planning & Commissioning Officer, Children, Education and Justice Services
Christine Farquhar Carer Rep, Edinburgh integration Joint Board
Ruth MacLennan Care for Carers
Laura Stirling Northwest Locality Hub Manager

Health and Social Care Partnership

Sune Skaarup National Policy and Engagement Officer, MECOPP
Lisa Mullen Contract Advisor, Children and Families
Glen Scott Edinburgh Carers Council
Tony Duncan Service Director Strategic Planning

Edinburgh Health & Social Care Partnership

Amanda Farquhar Head of Service

Youth and Families

Broomhouse Hub

Maureen Martin CEO, Edinburgh Development Group
Evidence Available – detail source Comments: what does the evidence tell you with regard to different groups who may be affected and to the environmental impacts of your proposal
Data on populations in need Carers in Edinburgh joint Strategic Needs Assessment (JSNA)

(see Appendix 1 of Carer Strategy)

The JSNA provides the context for Carers and the pressures and challenges that Carers are experiencing both at a national and local level around certain key areas including:

1.    Age & Gender

2.    Demographic Pressures

3.    Intensity of Caring

4.    Impact of Caring

5.    Cost of Living

It is estimated that there are currently between 50,000 and 70,000 adult carers in Edinburgh.

Data on service uptake/access annual performance report Commissioned partners provide end of year data re their services and key performance indicators.  This is drawn together and collated to form the annual performance report.

This year’s report shows that:

·       13 targets were exceeded

·       102 were met and

·       7 were partially met

·       14 were not met

·       1 is under development

Work to quantify the wider uptake and access to support through statutory services, individuals, community groups and organisations’ work is currently being carried out through the CLEAR action research and will be available later in 2023

Data on socio-economic disadvantage e.g. low income, low wealth, material deprivation, area deprivation. State of Caring in Scotland 2022 – A cost-of-living crisis for unpaid carers in Scotland

Heading for Crisis – caught between caring and rising costs
























The Voice of Carers Across Lothian (VOCAL) survey of Edinburgh carers 2021

The Department for Works and Pensions (DWP) data

“It’s hard work being poor” Women’s Experiences of the Cost-of-Living Crisis in Scotland, The Poverty Alliance, Nov 2022

WOMEN’S SURVEY 2023 Experiences of rising costs across Scotland

Scottish Women’s Budget Group

Unpaid carers have been among the groups hardest hit by the cost-of-living crisis in Scotland.




This report highlights the impact upon unpaid carers of the current cost-of-living crisis. It pays particular attention to carers financial challenges and how their sense of health and well-being are affected:

·       1 in 6 carers are in debt as a result of their caring role, increasing to 2 in 5 for carers in receipt of Carer’s Allowance.

·       The proportion of carers unable to afford their utility bills has more than doubled since last year to 14%.

·       Carers in receipt of Carer’s Allowance are more likely to be cutting back on food and heating.

·       Nearly all carers who are struggling to make ends meet (93%) agreed that the increase in the cost of living was having a negative impact on their mental and physical health.

Outlines the financial impact of caring, 69% of respondents reported that being a carer had a financial impact.

There have been increases in people reporting they have stopped or reduced employment and lost NI or pension contributions.  15% had to borrow money due to their caring role and 7% have had to use a food bank.

The Department for Works and Pensions (DWP) data shows that, in Edinburgh, 4,644 carers receive Carers Allowance and 250, sixteen- to eighteen-year-olds, received Young Carers Grants.  The number of people in receipt of Carers Allowance had been increasing annually but has recently plateaued.  The relatively low number of carers receiving carers allowance may be due to a number of factors including eligibility criteria, carer identification and that often pensioners become illegible for Carers Allowance once they receive pensionable income.  The number of young carers applying for, and receiving a Young Carer Grant has been increasing since the benefit launched in 2019.

This report shares the experiences of women in Scotland on low incomes affected by the cost-of-living crisis. Women are being disproportionately impacted by the cost-of-living crisis due to existing inequalities across all areas of life. They are more likely to be living in poverty, have lower levels of savings and wealth and are less able to increase paid work than men due to caring responsibilities.  The role of unpaid caring is significant for women in Scotland. 85% of those economically inactive due to caring are women’ the stat is referenced to the Scottish Government 2020 Gender Equality Index.

In total, 871 women from all 32 local authorities in Scotland took part in SWBG Women’s Survey from February to March 2023.The current cost-of-living crisis has not impacted everyone equally. Issues such as austerity, wage stagnation, rising inflation, and the impact of the Covid-19 pandemic, all impact women due to pre-existing structural inequalities. Rising costs have hit individuals on the lowest incomes the hardest. This disproportionately impacts women as they are more likely to experience poverty throughout their lifetime with lower levels of savings and wealth in comparison to men as well as being unable to increase paid work due to caring responsibilities.

Data on equality outcomes The Scottish Health Survey

Impact of Poverty on Women and Girls

2011 Scotland’s Census

MECOPP Briefing Papers based on data from 2011 Census:

Gypsy/Traveller Carers – May 2020

Informal Caring within the LGBT Community – August 2019

Self Directed Support and Scotland’s Black and Minority Ethnic Communities, June 2017

Informal Caring within Scotland’s Black and Minority Ethnic Communities, June 2017

The Health of Scotland’s Black and Minority Ethnic Communities

June 2017

Data Sources

The Voice of Carers Across Lothian (VOCAL) survey of carers.

Experiences of Older Adult Unpaid Carers in Scotland – Carers Trust Scotland – May 2023

It is estimated that 60% of carers are women.

Women are four times as likely to give up paid work due to multiple caring responsibilities and are more likely to be in low-paid, part-time employment than male carers.

The responsibility of care has significant ramifications on women’s access to employment, career development and progress, access to training and higher education, as well as on physical and mental health.

There is little recent evidence re particular issues arising in minority ethnic communities however we know that minority ethnic communities face significant inequalities with higher chances of living in poverty and disparity in access to affordable housing.  Minority ethnic people were also amongst the worst affected by COVID-19 19.  Being a carer in addition to being from a minority ethnic community will only increase the risk of poorer financial and well-being outcomes.  In the 2011 Scotland’s Census, in Edinburgh, 9.7% of carers identified as an ethnic minority.

In Edinburgh, the 2021, the Voice of Carers Across Lothian (VOCAL) survey of carers, reports that 41% of respondents reported more contact with health services about their own health (up from 35% in 2017).  67% reported that their physical health has been affected and 79% that their mental health has been affected compared with 59% reporting that being a carer made their health worse in 2017.

Survey of older carers over 65.  Key findings from respondents:

80% said their physical health had been affected by their caring role.

87% said that their health and wellbeing had been affected by their caring role.

65% said that they experience feelings of loneliness some of the time, and a further 19% said they often felt lonely.

18% feel as though they have no time for themselves.

82% felt as though their caring role has financially impacted them.

In the past12 months 37% have used gas and electricity as a way to save money, and 19% have skipped meals in the past 12 months.

Research/literature evidence The National Carers Strategy This strategy sets out a range of actions to ensure they are supported fully in a joined up and cohesive way
Public/patient/client experience information annual performance report

State of Caring in Scotland, Nov 2022, Carers UK

Case studies of people using the services are provided.

This report explores the key findings from our latest State of Caring survey.  The annual State of Caring report provides comprehensive research into the lives of unpaid carers in Scotland, along with the experiences of carers.

The 2022 State of Caring survey was carried out between July and September 2022 and completed by 2,044 unpaid carers across Scotland.

Evidence of inclusive engagement of people who use the service and involvement findings Carer Strategy annual performance report Feedback from service users
Evidence of unmet need As noted above

Care Inspectorate inquiry into Adult Carers’ Experiences of social work and care services  published December 2022

Care Inspectorate Report of adult social and social care services City of Edinburgh published March 2023

As noted above

The report highlights the need for improvement in support of adult unpaid carers and makes a series of recommendations. Inspectors from the Care Inspectorate carried out this work between March and July 2022

An inspection of adult social work and social care services in the City of Edinburgh which identified areas for improvement in adult social work and social care services in the City of Edinburgh

Good practice guidelines

Carers (Scotland) Act 2016: statutory guidance – updated July 2021

Equal partners in care

Independent Review of Adult Social Care

Self-directed Support (SDS) Improvement Plan 2023-2027

Carers’ charter – (

Statutory guidance for local authorities, health boards and integration authorities on effective implementation of the provisions of the Carers (Scotland) Act 2016 (‘the Act’). It will also be of interest to other organisations working alongside statutory bodies to deliver carer support.

Equal Partners in Care (EPiC) is a learning resource for health and social care staff to help have better conversations and interactions with carers. The aim is to make a positive difference and improve outcomes for carers and the people they care for.

Outlines the vision for improved health and social care support in Scotland.

The Self-directed Support (SDS) Improvement Plan 2023-2027 aims to take a whole system approach to the improvement of SDS, recognising that delivery partners across statutory, third and independent sectors all play an essential role in SDS improvement.  The SDS Improvement Plan 2023 – 2027 sets out the priorities to drive forward improvement in Self-directed Support over the next few years.  The plan recognizes that Self-directed Support should be the way that social care support is delivered for adults, children and young people, families and carers.

The charter aims to help carers understand their rights under the Carers (Scotland) Act 2016.

Carbon emissions generated/reduced data N/A
Environmental data N/A
Risk from cumulative impacts EVOC review of support with travel and short breaks and breaks form caring  for adults with disabilities or additional support needs and those that care for them,

EIJB Medium Term Financial Strategy & 2023/24 Financial Plan Update

All adult carer groups have been significantly affected by the pandemic. For example, there was suspension of short breaks/breaks from caring; participation in training/education; reduced employment opportunities and cessation of assisted transport services during the initial lockdown from March 2020.

In the long term, the cared for persons’ condition is likely to have progressed and the caring role to have increased in relation to this. Meanwhile the demand for carer support planning and assessment for the cared for person is increasing too.

The report outlines Phase 2 savings proposals for 2023/24 and a range of options which would be required to balance the plan in year.

Other (please specify)
Additional evidence required
Equality, Health and Wellbeing and Human Rights


Affected populations

The strategy encourages and assists individuals to identify as a carer and seek support at an early stage in their caring journey.  This early intervention and prevention approach will not only help ensure the wellbeing of carers but will also help us understand better any unmet need and aid improved measurement of the number of carers in Edinburgh.  This will allow us to collate evidence, understand and articulate the growing need for resource allocation to carer support and help lobby for further resource allocation for carer support from Scottish Government.

The strategy and supporting evidence referenced, recognises that a high percentage of carers are women and understands the additional pressures which women in particular, are facing.

Actions to encourage people to come forward as carers are included in the Strategy however all partners present were also asked to encourage carers to identify and come forward for support.

The Strategy aligns to the principles of Getting It Right For Everyone (GIRFE).  GIRFE is still in the early stages however it is unlikely that the principles will change.  These are:

•       Focused on individual care needs.

•       Based on an understanding of the physical and mental well-being of individuals in their current situation

•       Based on early intervention

•       Requires joined-up working/information sharing.

•       Based on a human rights approach

The Strategy recognises the Gender Pay Gap, how this affects women carers, the difficulties for women carers in getting access to training, the difficulties for women in maintaining employment if they are carers, that women often become lone parents if caring for children, that women often become carers of siblings if the parent dies and that the situation is worsening for this particular group.

The Strategy recognises that responsibility of caring is often unplanned and sudden (this can often be due to the death of a parent and a sibling may take on the caring role).  This transition stage is recognised in the strategy and actions to raise awareness of support for new carers are identified.

The needs of young Adult Carers will be further recognised in the development of the proposed Young Adult Carer Action Plan.

The strategy includes work to continue implementation of the Carer Support Plans.  Gypsy/Roma/Traveller communities, and other families which are moving through the area, will have the option of taking their plan with them if moving away from the area and this helps to reduce barriers to support.   There may be opportunities to better connect to the community working with these groups.  Opportunities for strengthening links to the community worker should be investigated.

The Strategy recognises that language can be a barrier, not only for those whose English is not their first language, but also because many people have caring roles but do not recognise themselves as carers.  For example, older gay men who care for their partners, often refer to themselves as a friend.  Some ethnic minorities do not regard themselves as carers. The use of inclusive language is acknowledged in training and refined through practice.

The Strategy recognises that a carer’s income and housing may change due to changes in circumstances of the cared for person for example if the cared for person goes into care or dies.  The Carer Support Plan can assist/be a prompt for these difficult conversations and can help identify support and assistance (getting back to employment for example) and aid longer term planning. Financial advice and information are a key priority of the Strategy.

There is a finite envelope of funding and it is vital that we ensure that we know what is working well and what does not work so well.  This will help ensure value for money and efficiency.  The Strategy identifies that a Performance Management Framework is currently being developed.

The Strategy has endeavoured to ensure that breaks from caring are organised on a locality basis, where viable, to try and ensure that travel time for the carer does not negate any break from caring time.  Transport is a crucial part of carer’s lives.

The Strategy recognises the valuable role which employers have in supporting carers and works to promote carer positive status in Edinburgh.  Work to advance carer friendly policies and enhance carer employer status for both NHS Lothian and CEC will be considered.

The Strategy prompts more choice and a creative approach to meeting needs, in particular through the use of SDS. (Options to buy more smaller services to give cumulative effect)


All although women in particular


The Strategy identifies links to other areas of development and strategies however joined up plans around these could be areas for further development.

The Strategy does not explicitly note any link to the Veterans covenant and the support which is available to veterans and their families.  There appears to be inconsistences in information available.

Environment and Sustainability including climate change emissions and impacts.


Affected populations

Goods, services and works will be procured in a way that supports the key priorities to tackle poverty through Fair Work, support initiatives that grow opportunities and capacity in the city, use community benefit spend to support disadvantaged communities and contribute to the impact of climate change on the city.





Affected populations

The cost of living crisis and economic considerations for carers, including employment, are a key aspect of the Strategy.

The Young Carer Action Plan which will be developed will consider transitions and employment.





    No further evidence is required.

Specific actions (as a result of the IIA which may include financial implications, mitigating actions and risks of cumulative impacts) Who will take them forward (name and job title Deadline for progressing Review date
Assess opportunities to better connect/strengthen links to community workers/communities with families which might be moving through the area. Edinburgh Carer Strategic Partnership Group (ECSPG)
Continue to encourage the use of inclusive language through training and in practice. ECSPG
The Strategy identifies links to other areas of development and strategies however joined up plans around these could be areas for further development. ECSPG
The Strategy recognises the valuable role which employers have in supporting carers.  Work to advance carer friendly policies and enhance their carer positive employer status for both NHS Lothian and CEC will be considered.  Best practice in other organisations to be considered e.g. Independent Living Fund Scotland. ECSPG
Opportunities to establish/strengthen carer staff groups/colleague networks/peer support groups at CEC and NHS Lothian will be investigated and encouraged. CEC/NHS Lothian
The Strategy does not explicitly note any link to the Veterans Covenant Fund Trust and the support which is available to veterans and their families.  Actions will be considered which will help ensure that consistent information is widely available. ECSPG

This proposal has been developed as part of the work from the Partnership’s Innovation and Sustainability Programme and will continue to be monitored within the wider programme. The impacts on different groups, including those with protected characteristics will be monitored through the programme working group and ongoing review of progress and challenges.

Tony Duncan, Service Director Strategic Planning, Edinburgh Health and Social Care Partnership

 Date:  25 July 2023

Completed and signed IIAs should be sent to:  to be published on the Council website

Edinburgh Integration Joint Board/Health and Social Care to be published at