The Care Act, which came into force in April 2015, for the first time puts unpaid carers on an equal footing with those they care for. So what has the impact been on the lives of carers?

Over the next few months I will be working with the Carers Trust and a team of experts by experience and professionals to try and answer that question. The Care Act: One Year On Commission will be holding hearings, calling for evidence and listening to carers of all ages. We are keen to get the views of frontline practitioners, and ask carers to complete a quick online survey.

It is plain is that the tone of the debate about the role of unpaid carers needs to change. Research has underlined how badly this is needed. Moved to Care took a look at the implications of UK migration policy for the future care workforce. Its stark conclusion is that there will be a shortfall of 200,000 people needed to meet the care of a larger older and more frail population. And Horizon 2035: Future Demand for Skills, found that demand for health and care skills could grow more than twice as fast as overall population growth by 2035.

Add to that the result of a poll for the Astellas Innovation Debate, which found that 52% of the public do not have confidence that the government will provide them with high-quality social care in later life, and the picture is stark. There is an enormous and expanding gap between demand and provision.

These findings raise serious questions about how our health and care systems will adapt to workforce shortages that dwarf the current funding challenges. Business as usual is not sustainable. Even if the money was there to pay for the workforce that will be required, it will be hard if not impossible to recruit the numbers needed.

In the end, it is carers who will be left to pick up the pieces – family and friends, who out of love, solidarity, circumstance or duty find themselves taking on a caring role. This can include anything from practical tasks, such as cooking, housework and shopping, to managing the family budget, collecting benefits and prescriptions. There is also emotional support, or physical care, such as lifting, as well as personal care, such as dressing, washing and helping with toilet needs. It can be exhausting, it can be rewarding, either way it takes a toll.

The evidence of the negative health and wealth impacts (pdf) of caring is well documented. The impact on the labour market and the wider economy (pdf) is just beginning to be understood.

In the week that NHS England published its long awaited Mental Health Strategyit should come as no surprise that an analysis of the GP Patients Survey reveals that carers are much more likely to report feeling depressed or suffering from anxiety, particularly young carers. The Mental Health Task Force has some positive things to say about involving carers (pdf) and offering them support. But the sad truth is that the NHS remains largely carer blind, leaving it to children’s services and adult social care.

During the legislative scrutiny of the Care Act, I argued there needed to be a duty on the NHS as well as councils to identify carers. Spotting and supporting carers earlier would pay double dividends, helping the individual maintain their own health and cope better.

Over the next few months I hope the commission will put a spotlight on these issues, celebrating good practice, highlighting where the act has made a difference and where it has not.

The chronic funding pressures on social care are undermining the efforts even of the most committed councils. But unless we start getting support for carers right, the NHS and social care will not have the workforce to pick up the pieces.