- The author states that the current development of a national carers' strategy is a significant milestone after two decades of campaigns and policy development to draw attention to the unpaid help that families and friends provide. Various questions are asked: how far have we travelled in meeting the needs of carers?: what has been achieved over the last years of raising the profile of carers and developing support services and benefits?: and in which direction should we be heading as the new health and social care agendas take shape and strive to improve the mesh between, and within, the formal and informal care systems? This paper aims to describe the current picture, discuss why it looks like this and to suggest what needs to be considered as national and local policies are developed and implemented. It draws on the work of the Carers Impact development programme based at the King's Fund and other recent research.