We have been working together to take forward The National Carers’ Strategy, published in 2008 alongside the promotion of more personalised support and sustained independence. This paper is the fourth in a sequence of short reviews designed to stimulate debate and improve support for carers. It links closely to Commissioning for Carers . The focus of this paper is to help us all to tackle the following question: How will you, carers, and people more generally know if you have improved outcomes for people who give and receive care and support? It is a question not easily answered.