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

Estimating the impact on successful applications

Given the limited data available, applying the responses from the Delphi study is our best indication of how the BASRiS guidance might impact the number of people receiving Disability Assistance because they are terminally ill. However, there is considerable uncertainty when applying the Delphi output.

As with any Delphi exercise, the results are the synthesis of opinion of a particular group of experts, and surveying another group may have resulted in different figures.

Data is available on the main disabling condition of people receiving PIP because they are terminally ill. This shows over 80% of individuals receiving PIP because they are terminally ill and over 90% of people successfully applying for PIP due to a terminal illness have malignant disease. Estimating the impact of the new guidance on individual conditions other than malignant disease is very uncertain given the small volumes involved. Therefore, for ADP, this analysis considers malignant disease separately as the main driver of any changes, and looks at all other conditions as a group.

Given the responses from the panel shown in Table 1, this leads to an assumption that for ADP the number of people successfully applying due to terminal illness will be 92% higher than PIP for those with malignant disease, and 57% higher for all other conditions. When combined, this would equate to a 90% increase in the number of people successfully applying for ADP because they are terminally ill.

Currently in Scotland around 25 people receive child DLA due to terminal illness and no information is available on their conditions. The panel estimated that the number of successful applications for CDP would be 10% higher than for child DLA.

Similarly, no information is available on the conditions of people receiving AA because they are terminally ill, therefore the overall assumption for the ADP increase of 90% is used for PADP.

The corresponding number of successful applications by people who are terminally ill this would lead to, and the current number under the DS1500 rules, are shown in Table 2.

Totals may not sum due to rounding.

These estimates would mean the number of people receiving Disability Assistance because they are terminally ill would triple. This would be a culmination of the increased applications, but also that people would receive the assistance for an additional 10 months (around 60% longer than in the current situation).

The panellists agreed that any increase in the number of people eligible due to terminal illness would be more likely to affect older people, but this is difficult to model given the lack of information on the conditions of the people receiving AA because they are terminally ill. One possible source of information from the panellists on the effect on older people is the estimates given for frailty as a condition. The panel estimates successful applications due to terminal illness from individuals with frailty (along with one or more co-morbid conditions) would increase by around 130%, the highest estimate of any condition. This may suggest the estimates for PADP could be increased instead of using the same estimates as for ADP.