The Carer Support Unit of the Central Coast Local Health District (New South Wales, Australia) is working with the District's inpatient cancer services to improve the identification of caring relationships for cancer inpatients. The first stage of the project was to do a literature review and environmental scan to assess the extent of the issue. We found significant barriers to carer identification, including: carer self-identification issues; definitional issues around the label 'carer'; system and process issues; and health workforce issues. This article outlines the findings of the literature review and environmental scan, supported by quotes from carers and health professionals. It incorporates recommendations for increasing the rate of carer identification for cancer inpatients at Central Coast Local Health District.