Research and analysis

Research summary

Published 15 March 2023

Authors: Alison Beck, Thomas Barber, Malen Davies, Ella Guscott, Dr Helen McCarthy, Dr Martin Mitchell, Nilufer Rahim, Lana Yee (NatCen)

This is a summary of findings from a large-scale qualitative research study exploring how health and disability benefits (including Personal Independence Payment, Disability Living Allowance, Employment and Support Allowance and Universal Credit) are used by recipients alongside other sources of provision and support to meet health and disability related needs.

Context and aims

In recent years, the Government has committed to improving support for disabled people and building an evidence base to inform the design and delivery of future services. This research was commissioned in 2019 to contribute to that evidence base by exploring how health and disability benefits, alongside other sources of provision and support, are used by claimants to meet their health and disability related needs.

The key aim of the research was to examine how health and disability benefit recipients incorporate different benefits into their household budgeting; how they spend these benefits; and what drives these spending behaviours.

Methodology

The research consisted of 120 in-depth interviews with recipients of health and disability benefits conducted between July and September 2019. Interviews were clustered in eight locations in England, Scotland and Wales, encompassing rural villages, rural towns, urban towns and a major urban conurbation. The sample included individuals receiving different combinations and rates of benefits, with a variety of health conditions or disabilities and differing severity levels.

Key Findings

Financial circumstances and money management

Participants’ financial circumstances varied widely and were affected by a range of factors, beyond simply their level of income. These factors included: the level and stability of income; debt levels; the numbers and types of health condition or disability in the household; housing type and quality; and proximity to healthcare.

Health and disability benefits were incorporated into household finances in two main ways: pooled with other income or treated distinctly. Pooling income was widespread across the sample and this approach obscured the precise use of health and disability benefits. This meant it was not always possible to identify how health and disability benefits were used to help meet needs. When looking at household income as a whole, the most significant expenditure was on essential day-to-day living costs, including utility bills, groceries, mortgage/rent payments and car expenses.

Areas of additional need relating to participants’ health conditions and disabilities

Additional health-related needs spanned across all areas of participants’ lives, including personal care, treatment and aids, support within the home, support going out and help with social participation. These additional needs often resulted in extra costs, ranging from health-specific costs such as for care, medical equipment or therapies, to increased essential day-to-day living costs such as for utilities, clothing and transport.

Those with severe or multiple conditions reported more needs, or more consistent needs, than those with less severe conditions or single conditions. However, some participants, particularly those with mental health conditions, had substantial emotional support needs which were less immediately visible, despite having a significant impact on their lives.

How additional needs in relation to health conditions and disabilities were met

Health and disability benefits, alongside other income streams, helped to meet almost all identified areas of additional need stemming from participants’ health conditions and disabilities. However, informal support networks, health and social care services and the community and voluntary sector also played an important role in meeting these additional needs.

Health and disability benefits were also key in passporting to other essential benefits such as free prescriptions and support from local authorities, such as free travel. Schemes such as Motability, which can only be accessed by those in receipt of certain benefits, also helped to meet participants’ travel needs.

Factors driving how health and disability benefits were used

The way in which benefits were used was highly influenced by the wider context of resources available to participants, including their financial circumstances, availability and awareness of free formal support and the strength of their informal support networks. These factors also influenced the degree to which additional health-related needs were met, with those with limited financial resources having to prioritise essential day-to-day living costs over other health-related needs. However, participants across the financial spectrum described a range of unmet needs in relation to social participation and mental health support.

Overall, health and disability benefits were a key element of the support that is available. For those with restricted financial circumstances they offered a regular income which provided reassurance that some of their essential day-to-day living costs would be met. However, some of this group reported that they were still unable to meet essential living costs such as food and utility bills.

Participants’ suggestions for improvements

Participants made a number of suggestions for improving support both from DWP and other agencies. Suggestions included greater awareness-raising and signposting to benefit entitlements; enhancing services provided by Jobcentre Plus; increasing the amount of certain benefits; and giving claimants more choice over when, how frequently in and in what way benefit payments are made.