Digital care tech’s double edge for unpaid carers

Digital care technologies risk deepening inequalities and increasing pressure on unpaid carers if not implemented carefully, writes Dr Ekaterina Hertog, associate professor in AI and society at the Oxford Internet Institute, University of Oxford

Nearly nine million people provided unpaid care in the UK between 2023 and 2025 – one in six of all UK adults.

The support they give to family, partners, friends and neighbours because of illness, disability or age is also a vital support to our health and care services.

Take away that pillar, and you would soon bring the NHS and local authorities to breaking point.

So what does the current health and care reform agenda offer for our unpaid carers, given its focus on data and technology to drive efficiencies and improvement?

Will it help them to care for their loved ones or could it lead to unforeseen consequences that will not only impact them but also their role in supporting the wider health and care system?

Take away unpaid carers, and you would soon bring the NHS and local authorities to breaking point

The recent evaluation of the Accelerating Reform Fund (ARF), introduced by the last government, could start to answer that question.

The ARF provided £42.6 million in grant funding from 2023 to 2025 to support innovation in adult social care.

The fund laid out 12 priorities, five of which were focused on unpaid carers.

Many, though not all, of the projects funded were to develop new technologies to help identify unpaid carers (many of whom go under the radar and so receive no support) and to create online communities to provide digital support and resources.

The evaluation of the fund, published at the end of last year, assesses the short-term outcomes but does not ask harder questions like: what do technologies do to carers over time, do they change the nature of care, and what risks lie beneath the surface?

That is what colleagues and I set out to examine in our own research, drawing on evidence from 83 studies on the impact of digital technologies on unpaid care work in the US, Europe, urban China and South Korea.

Benefits and blind spots

We found that, in the studies analysed, digital technologies provided very similar benefits to those highlighted in the ARF evaluation, in particular in improving coordination and providing access to a supportive online community.

But we also identified longer-term risks. Evidence from these global research studies showed that people who could benefit most from digital care technologies are often the least able to access them.

Any implementation of technology needs to address the digital divide – the gap between those with reliable internet, up-to-date devices and technical skills, and those without.

Those who could benefit most from digital care technologies are often the least able to access them

When it comes to unpaid carers, this divide is particularly stark.

The ARF evaluation found that younger, more able carers are quickest to engage with new digital tools, while older, more isolated and disadvantaged carers lag behind.

This potentially widens the ‘care advocacy gap’, where those already best at seeking support gain access to a broader, more personalised offer.

Consider this in the light of UK statistics, which show that older people and those from disadvantaged areas make up the biggest proportion of unpaid carers.

Data, privacy and regulation

The ARF evaluation highlighted the need for better standards and guidelines around the adoption of digital tools.

Again, this mirrored our findings, which showed a clear need for better regulation that specifically addresses both data governance and privacy issues around care technologies – both within families and with tech companies.

This is not an area that should be purely left to market forces, given how essential care is to society

Tech companies are often opaque about how they gather and use data, with people having little control over the process.

In some places like the US, the regulations that govern this area are weak. In Europe, they are incomplete, with specific provisions protecting children’s, but not vulnerable adults’ data.

This is not an area that should be purely left to market forces, given how essential care is to society.

The risk of burnout

One central theme of many of the studies we analysed was carer burnout – already a risk given the nature of unpaid care.

Digital technologies in theory can reduce workload, but their ‘always on’ nature can blur the line between ‘care’ and ‘life’ and actually increase the pressure on carers.

Unpaid carers are also turning to digital technologies to help them deliver care, often with little understanding of how these technologies can fundamentally change the relationship between carer and cared for.

Digital technologies can blur the line between ‘care’ and ‘life’ and actually increase the pressure on carers

They can reduce complex care relationships – built on listening, understanding and trust – to quantifiable metrics and active surveillance, at the expense of the emotional dimensions of care. They can also substitute remote support for close human contact.

Both carer burnout and deterioration of relationships are a risk for health and care systems. If carers can no longer provide their support, then the state must step in.

Keeping care human

While there are definite positives that can come from digital care technologies, helping both carers and the cared-for, what matters most is that people have the right and the real ability to choose the kind of care they want to provide and to receive.

Like many digital technologies, care tech works best when used to support positive human relationships, not replace the physical connection that is at their heart.

To learn more about this issue listen to the latest episode of the Digital Health Unplugged podcast which explores if the ‘shift to digital’ risks worsening healthcare inequalities.