Estimating the impact of the new definition of terminal illness for disability assistance in Scotland: research

Delphi Findings

The panel agreed that, depending on the condition, the number of people eligible because they are terminally ill would either stay the same or increase. The main reasons given why there could be an increase in the number of people eligible were:

• Removing the expectation that the patient is likely to die in the next 6 months.
• For conditions other than malignant disease, clinicians and patients may not be aware that they are currently eligible for benefits if they are terminally ill, and the new guidance might raise awareness of the ability to apply under this route.
• Clinicians may be more prepared to discuss with their patients that their condition is incurable and present the option to apply under terminal illness rules when not constrained by needing to provide a prognosis of 6 months or less.

We asked the panel to estimate how the number of people eligible due to terminal illness might change. A 100% increase would mean the number of cases double. The average responses in the third round of the survey is shown in Table 1.

There were some conditions where most of the panel (over 70%) responded that there would likely not be a change in the number of people eligible. These were gastrointestinal disease, genitourinary disease and musculoskeletal disease. As this was not unanimous, a small increase of 5% was assumed for these conditions.

It should be noted that the conditions included in PIP data are described as the "main disabling condition" and there isn't any information on the other conditions a person could be experiencing. The panel suggested that, for example, where someone is terminally ill and has diabetes, it's likely they are terminally ill because of a complication, such as heart failure or renal disease. They commented that it is likely these complications would lead to the increase in eligibility for those with endocrine disease rather than being eligible through diabetes itself.

The panel agreed that people who would have received benefits because they are terminally ill under DS1500 will likely apply for benefits earlier under the BASRiS guidance. This is due to the removal of the 6 month time limit, and would mean they receive the benefit for longer. The panel estimated that people would be eligible 10 months earlier than they are currently.

Analysis of the number of people currently receiving and successfully applying for PIP due to terminal illness suggest that, despite the 6 month rule, on average people receive PIP because they are terminally ill for around 16 months. The responses from Delphi suggest anyone successfully applying for ADP under the BASRiS rules would on average receive ADP due to terminal illness for 26 months.