Understanding the drivers of changes in demand for disability benefits in Scotland since 2010: A quick scoping review

1. Executive summary

The aim of this Quick Scoping Review is to identify, summarise, and synthesise research that examines the different drivers of demand for disability benefits in Scotland and the UK since 2010.

Non means-tested disability benefits were devolved to the Scottish Government in 2020. Social Security Scotland began the delivery of new disability benefits in Scotland with the introduction of Child Disability Payment (CDP) in 2021 and Adult Disability Payment (ADP) in 2022.

There has been a large increase in the number of working-age adults and children receiving disability benefits in Scotland and the UK over the last 15 years.

The rise in disability benefits caseloads in Scotland and the UK has not been mirrored in other similar countries^[1] and demand for disability benefits is projected to continue to grow in Scotland and the UK. The aim of this review is to improve understanding of the drivers of demand for disability benefits in Scotland through a systematic analysis of the evidence.

A quick scoping review methodology was chosen for its rigour and transparency. This approach systematically maps the research carried out in an area, provides an overview of the volume and characteristics of the evidence base, and helps identify existing gaps in knowledge.

The review screened 350 sources published between 2010 and June 2025, which addressed the primary question: What are the drivers of changes in the overall number and profile of people applying for and receiving disability benefits over the last 15 years in Scotland and the UK?

It examined the extent to which changes in demand for disability benefits have been driven by five potential drivers, which were decided on by the expert Research Advisory group and informed by the literature. These drivers are changes in: population health; the economy and labour market; the design and operation of the benefit system(s); attitudes and behaviours; and demographic changes. No other key drivers emerged from the analysis.

Of the 350 sources identified, only 23 met the inclusion criteria - 14 of these examined the drivers of disability benefits specifically, while nine of the 23 included work-related (‘incapacity’) benefits or discussed ‘health-related’ benefits (which refers to disability and work-related benefits together). [In order to ensure that findings are correctly represented, this report uses the terms used in the original source publication. However, it is important to recognise that in several areas, terms are contested and that different organisations use different terminology. The Scottish Government adheres to the ‘social model’ of disability and therefore prefers to avoid terms such as ‘incapacity’ in reference to work-related benefits and ‘health-related’ benefits (which combines benefits that are provided for different purposes).]

The review highlighted a lack of primary research evidence across the five drivers. Only two reports included primary research. Most of the sources were reports by think tanks, policy and research organisations and independent fiscal institutions.

While the focus of this quick scoping review is on understanding the position in Scotland, only six of the sources included a separate analysis of data or discussion of Scotland and the remainder focused on the UK or England and Wales. While the review sought to examine the drivers of demand for disability benefits over the last 15 years, many of the sources sought to explain changes that have occurred since the Covid-19 pandemic by comparing the position prior to the pandemic, with the current / or more recent post pandemic position.

1.1 Key findings

1.1.1 Context

To set the context, the review began by asking how demand for disability benefits in Scotland has changed, who is in receipt of disability benefits and how the profile of recipients has changed over the last 15 years.

The review found that the number of working-age adults and children receiving disability benefits in Scotland has increased substantially since the early 2010s. The rise in caseloads has been particularly pronounced since the Covid-19 pandemic in Scotland and the UK, with a spike in disability benefit applications in Scotland following the introduction of ADP and CDP.

Over recent years the age profile of new recipients of working-age disability benefits in Scotland (PIP and ADP) has changed and now includes a larger proportion of younger people. There has also been an increase in the proportion of people receiving working-age disability benefits due to the impact of ‘mental and behavioural disorders’ and circulatory diseases.

1.1.2 Primary question

To answer the primary review question, the review examined and presented the drivers of disability benefit demand separately but highlighted the interrelationships between different drivers. The number of evidence sources relating to each of the drivers is set out below:

• Changes in population health – 18 sources
• Changes to the design and operation of the benefit system(s) – 17 sources
• Changes in the economy and labour market – 11 sources
• Changing attitudes and behaviours – 7 sources
• Demographic changes – 4 sources

1.1.3 Changes in population health

Review findings show that the rise in the share of the population who report being disabled or in ill-health mirrors, and may at least partially explain, the rise in disability benefit caseloads.

Population health was declining before the pandemic, but this decline has accelerated and continued since. There has been a large increase in the number of people receiving health-related benefits due to the impact of ‘mental and behavioural disorders’, and the number of disabled children in the UK since before 2010 (proportionate to working-age adults). This is mirrored by the increase in the number of children in receipt of child disability benefits.

The review did not identify evidence to suggest that NHS waiting lists are a driving factor in explaining the recent rise in health-related benefit claims. However, some contribution cannot be ruled out given that the evidence on this is limited, and there is some emerging evidence^[2] that does indicate a link between rising take up of disability benefits and challenges in the healthcare system.

1.1.4 Design and Operation of the Benefit System(s)

The transition from Disability Living Allowance (DLA) to Personal Independence Payment (PIP): the sources reviewed attributed the increase in disability benefit caseloads (at the UK level) following this transition to: the migration and early delivery challenges associated with the transition to PIP, and the policy design of PIP, including higher than expected numbers of people who were eligible for PIP.

There was no conclusive evidence, in the sources reviewed to show that the introduction of ADP in Scotland has led to the increase in caseload seen in Scotland since its launch. Evidence from previous reforms suggests that it takes many years for disability benefit caseloads to stabilise following the introduction of a new benefit. It may therefore be premature to assess whether the devolution of disability benefits in Scotland has driven up caseloads in the post-pandemic period and longer term data will be required to understand the changes in caseloads more fully.

Around a quarter of the sources examined whether changes to the PIP application and assessments processes had driven up caseloads. None of these sources provided evidence to suggest that it has become ‘easier’ to be awarded PIP since its roll out, which is demonstrated by steady award rates over time. There was a lack of evidence generally on the effect of changes in PIP assessment approaches due to the Covid-19 pandemic on disability benefit caseloads and none of the four sources that examined this provided robust evidence to show these changes had contributed to increased PIP caseloads. Some reports found that PIP caseloads are increasing (in England and Wales) partially because of longer award durations and fewer people coming off PIP over time, in part due to less frequent reassessments. There was no robust evidence to demonstrate that the financial value of disability and health-related benefits relative to unemployment benefits has increased applications for disability benefits.

1.1.5 Economy and the Labour Market

There was no robust evidence to suggest that demand for disability benefits has been driven by the economy and/or the labour market since 2010. Most commentary was on the role of the cost of living crisis as a driver, and around a third of the sources examined whether the cost of living crisis and worsening economic conditions since the pandemic have been a driver of disability and health-related benefits caseloads. However, the findings were mainly discursive and speculative. Two studies indicated that while worsening labour market conditions have played a minor role in explaining the increase in disability benefits post pandemic, recent labour market changes were not a key driver of the rise in caseload.

1.1.6 Changing Attitudes and Behaviours

There was a lack of primary research evidence on how changing attitudes and behaviours may be a driver of changes in demand for disability benefits. Most of the findings related to increased awareness of disability benefits, through information and support, but some sources highlighted the increased awareness of health conditions, particularly mental health problems/conditions^[1] which they speculated may have increased willingness to apply for disability benefits.

1.1.7 Demographic Changes

Demographic changes, in particular population ageing and the consequences of an increased state pension age were found to be drivers of increased disability benefit caseloads. Few studies quantified the contribution of different drivers, but the Resolution Foundation provided estimates of the extent to which demographic changes have contributed to the rise in disability benefit caseloads. It found that an ageing population and rising state pension age explained one-quarter of the increase in the working-age disability benefit caseload in England and Wales between 2013-2023, and one-fifth of the rise in working-age health-related benefit caseloads. They also estimated that the combined effect of population change, and the rising incidence of self-reported disability explains 87 per cent of the increase in disability benefit caseload between 2013 and 2023.

1.2 Conclusion

The question of what is driving recent increases in disability benefit caseloads has been the subject of intense media and political speculation. Findings from this quick scoping review indicate key contributors but also highlight significant evidence gaps.

This review found that there is evidence to suggest that changes in population health (particularly declining mental health but also increases in other health conditions^[2]) and demographic changes (notably an ageing population and rising state pension age) have driven demand for disability benefits.

Additionally, there is limited evidence that the design and operation of the benefit system(s), or changes in the economy and labour market, and in attitudes and behaviours explain the increase in disability benefit caseloads. These are commonly offered as explanations in public discourse. However, they are often based on conjecture and not supported by robust evidence at the current time. As a result, it is not possible at this stage to understand their relative contribution or rule them out as important drivers of increased disability benefit caseloads.

Most of the sources reviewed discussed / examined the drivers of demand in relation to several or multiple intersecting drivers and surmised that the rise in disability benefit caseloads is not attributable to a single driver.

The review did not identify other, previously unrecognised drivers of disability benefit demand and caseloads. However, the impact of cuts to public services on people’s mental and physical health and the role of investment in policies with an explicitly preventative purpose (such as high quality mental health services in schools and interventions to support the needs of people with neurodevelopmental differences) was relatively unexplored in the sources identified and could also influence demand for disability benefits.

The report concludes by highlighting the lack of Scottish evidence and the key evidence gaps. These should be addressed by future research.