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

7. Conclusions

7.1 Current state of research

While there are a number of sources that discuss the drivers of disability benefit caseloads in the UK and Scotland over the last 15 years, there is a lack of robust evidence on the individual and joint contribution of these drivers. The majority of the sources that met the inclusion criteria for the review involved secondary analysis or commentaries rather than primary research. As a result, it is challenging to draw robust conclusions and there is a need for longitudinal studies tracking people’s interactions with and experiences of the benefit system(s).

7.2 Areas where evidence is available

More evidence was found on changing population health and changes to the benefit system(s) as drivers of demand for disability, and health-related benefits, than other drivers. Evidence on the contribution of these drivers was mostly available at the UK, or England and Wales level.

7.3 Areas where there is less evidence or evidence gaps

The following research gaps were identified:

7.3.1 Populations that have been understudied

Only five of the 23 sources examined child disability and changes in child disability benefit caseloads. This dearth of evidence is striking given there has been a large increase in the number of disabled children in the UK since 2010, and the proportional rise in reports of disability in children has outpaced that for working-age adults. Insight into these drivers will be important, in understanding the transition from CDP to ADP (and Child DLA to PIP) and prevalence of demand amongst young people.

The findings of this review show that there are clear knowledge gaps around Scottish evidence on the drivers of disability benefit caseloads. 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, highlighting a scarcity of evidence on the drivers of demand for devolved disability benefits in Scotland. There is a need for primary research in Scotland, and for substantiated and evidenced findings on the drivers considered.

7.3.2 Methodologies that have not been widely applied

The report by SHERU^[329] identified several methodological limitations, including the limits to which quantitative data can provide a full understanding of the drivers of demand for disability benefits. SHERU highlighted the role of qualitative analysis in improving understanding of drivers behind the increased disability benefit applications, such as understanding whether more people are taking up their entitlements, and if the increase is attributable to worsening health or other factors.

SHERU also highlighted the limitations of the quantitative data available in Scotland, and the need for more detailed breakdowns on conditions, to allow intersectional analysis.

7.3.3 Questions that remain unanswered or inadequately addressed

There is a lack of robust evidence on attitudinal changes towards disability and disability benefits since 2010 and how that may influence disabled people’s likelihood to apply for disability benefits. An example is the lack of evidence to demonstrate whether there has been a reduction in stigma around applying for and receiving disability benefits which has acted as a driver of caseloads. There is also an evidence gap around whether enhanced awareness by GPs of certain health conditions is influencing disability benefit caseloads, despite the fact that a health condition diagnosis is not required to successfully apply for health-related or disability benefits. While one source investigated the relevance of online content creators in providing advice and support around the application process for disability benefits, no evidence was found on whether this had contributed to the increased caseload. None of the sources reviewed included findings on the emerging use of Artificial Intelligence in disability benefit applications and assessments.

While there was a large evidence base examining the relationship between the labour market and incapacity benefits, far fewer sources were found that examined the labour market as a driver of disability benefits. Around a third of the sources examined whether the cost of living crisis and worsening economic conditions since the pandemic have driven disability and health-related benefits caseloads. However, there was no analysis of change over time or causal evidence of increased take up amongst disabled people - who had previously been eligible for disability benefits but chosen not to apply for them - due to the need for financial support because of the cost of living crisis. This points towards an important gap in the evidence.

One primary source was found which examined the relationship between NHS waiting lists and the recent rise in health-related benefit claims. More research on NHS waiting lists and disability benefits specifically would be valuable.

The section on demographic changes highlights analyses which quantified the contribution of a rising SPA and ageing population to increases in disability and health-related benefit caseloads. The SPA is rising again with implications for disability benefits, as a higher proportion of people aged over 50 have health conditions.^[330] Projections produced by the Office for National Statistics show that the UK’s population is ageing and that in 50 years’ time, there are likely to be an additional 8.6 million people aged 65 years and over.^[331] As of October 2024, around a fifth (22%) of the total ADP caseload were people aged 65 and over.^[332] Further research in this area will be important in meeting future challenges related to demographic changes. People who start receiving ADP before reaching SPA can continue to receive it after reaching that age, and so there are implications for the forecasted proportion of ADP and PIP recipients of pensionable age.

There are few studies that seek to quantify the contribution of different drivers. Evidence which further examines the interactions and interplay between drivers of disability benefits would be valuable.

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.