UK: People With Disabilities - World Health Systems Facts

Population aged 15 years and over rating their own health as bad or very bad, 2021: 7.4%
Adults aged 65 and over rating their own health as poor or very poor, by income, 2018
– Lowest quintile: 13%
– Highest quintile: 6%
– Total: 12%
Limitations in daily activities in adults aged 65 and over, 2018
– Severe limitations: 21%
– Some limitations: 24%
Estimated prevalence of dementia per 1,000 population, 2021: 12.7
Estimated prevalence of dementia per 1,000 population, 2040: 16.2

Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.

Percent of Population Aged 16 and Older Reporting Limitations in General Activities: 27.3%

Source: Statistics on Persons with Disabilities, Master tables concerning EU 2020: year 2018, Prepared for the European Disability Expertise (EDE) By Stefanos Grammenos (in collaboration with Mark Priestley), Sept. 11, 2020.

“In 2021/22, the UK was forecast to spend £58 billion (€69.52 bn) on benefits for people with disabilities and health conditions.² Much of social security provision is UK-wide. There are devolved powers for some aspects of social protection, however. We focus primarily on England as the most populated area of the UK, but in some cases specify differences between provision there and in Scotland, Northern Ireland and Wales. Some benefits are also available at local authority level.

“There are some specific benefits for war veterans and for industrial diseases / injuries and these are described below in the appropriate sections. Over time, the proportion of resources devoted to means-tested benefits and those for additional costs (means-tested or not) has increased in relation to non-means-tested contributory benefits.³

“Some benefits can be a route to others (which are called ‘passported benefits’).⁴

“There are special rules for some benefits for people with terminal illnesses.⁵“

Source: Bennett, Fran and Glendinning, Caroline (2022). ESPN Thematic Report on Social protection for people with disabilities – United Kingdom, European Social Policy Network (ESPN), Brussels: European Commission.

“Over the past decade, many working age benefits were frozen or raised by less than inflation in different years, sometimes for several years at a time.⁸⁸ However, benefits for people with (more severe) disabilities, and elements of general benefits specific to people with disabilities, were not affected in the same way. This does not imply that such benefits were, or are currently, adequate, however.⁸⁹

“The Westminster government commissioned qualitative research about the uses of health and disability benefits in England, Scotland and Wales, but has refused to publish the resulting report (on the grounds of needing a private space in which to discuss policy),⁹⁰ despite a protocol suggesting it should do so. This mirrors other evidence that the DWP does not necessarily find it easy to be open in discussing policy options.⁹¹ The House of Commons Work and Pensions Select Committee used its powers to publish the report.⁹²

“The report concluded that the way these benefits were used was influenced by wider circumstances, and that (p4): ‘for those with restricted financial circumstances … some … reported that they were still unable to meet essential living costs such as food and utility bills’; and (p63): ‘Participants with very limited financial resources in particular said that an increase in benefit payments would improve their overall wellbeing’.

“The Resolution Foundation recently argued that ‘unemployment benefit in 2022-23 will be at its lowest level in real terms since 1990-91 and is only slightly above an estimated destitution income level of £70 per week. As a proportion of average earnings, it now stands below 14%, half the level it was in the 1970s’.⁹³ But those on New Style ESA get the same level of benefit as this, unless they are entitled to the support component; so they are affected in the same way.”

“Long-term care in the United Kingdom is a blend of health and social care, provided in a combination of residential/institutional care and care provided in the community within people’s homes (Cylus et al., 2015). The NHS funds long-term care for patients with “complex health needs”, through schemes such as NHS Continuing Health care in England, and Hospital-Based Complex Clinical Care in Scotland. However, the NHS will not fund “nonhealth care” aspects of long-term care, known as social care, which is funded through a mixture of public and private funds according to varying eligibility criteria across the United Kingdom’s constituent countries (see Section 3.4.2, Direct payments). The distinction between long-term non-health care and long-term health care needs is dependent upon a multidisciplinary assessment that takes account of the intensity and complexity of the support required across a series of care domains (Department of Health & Social Care, 2018b). Long-term care is provided to older people; people with physical disabilities, frailty and sensory impairment; people with learning disabilities; people with mental health problems; people who misuse substances and to other vulnerable people.”

Source: Anderson M, Pitchforth E, Edwards N, Alderwick H, McGuire A, Mossialos E. The United Kingdom: Health system review. Health Systems in Transition, 2022; 24(1): i–192.

“The 2021 National Disability Strategy¹¹⁴ involves all government departments, but the proposed short-term actions do not include any proposals on benefits. The DWP does have a short section in it (pp112-113), saying that it ‘will take action to remove the barriers disabled people face at work and set out proposals to improve access to support for disabled people who cannot work’. But the only reference to social security provision is about ‘proposals to improve the experience of accessing disability benefits’ (see Section 4.2.4, Assessment processes for ESA, UC and PIP, below). See Section 4.3 below for the smaller nations’ actions.

“The UK-wide National Disability Strategy has been judged unlawful¹¹⁵ by the High Court, due to inadequate consultation with people with disabilities (p12); but the government is appealing against the judgment.¹¹⁶ The Equality and Human Rights Commission is also reported to have abolished its advisory group of people with disabilities.¹¹⁷ The independent Social Security Advisory Committee had already published a report on working age benefits suggesting the government thought lack of trust from people with disabilities made reforms harder to introduce, and proposing ways to improve this, including a protocol for DWP engagement.¹¹⁸ The Strategy is referred to in the government’s follow-up report to the UN Committee on the Rights of Disabled People after its 2016 inquiry.¹¹⁹“

Source: Anderson M, Pitchforth E, Edwards N, Alderwick H, McGuire A, Mossialos E. The United Kingdom: Health system review. Health Systems in Transition, 2022; 24(1): i–192.

“Residential or nursing care is provided in homes specifically for that purpose, provided by a range of for-profit and not-for-profit independent providers. “Supported” residents are those who are deemed as eligible to receive financial support from local authorities to live in their residential or nursing care home (see Section 3.4.2, Direct payments). However, eligibility criteria have remained unchanged for over a decade, meaning that due to inflation, each year fewer people are eligible for financial assistance for their social care needs. The Care Quality Commission regulates and inspects all social care providers in England, including care homes, nursing agencies and home-care agencies, based on standards established by the Department of Health in 2000 and amended in later legislation. The Care Inspectorate registers and inspects care homes in Scotland, whereas the Care Inspectorate Wales (a separate institution) registers and inspects care homes in Wales. The Regulation and Quality Improvement Authority is responsible for registering and inspecting all health and social care services in Northern Ireland.”

Source: Anderson M, Pitchforth E, Edwards N, Alderwick H, McGuire A, Mossialos E. The United Kingdom: Health system review. Health Systems in Transition, 2022; 24(1): i–192.

“Even though adult patients with developmental disability are considered a high-need patient group, few studies have investigated patient safety incidents specifically in this population.^17–20 Existing research reported that patients with developmental disability received lower-quality hospital care processes²¹—for example, during chemotherapy and certain surgical interventions—and experienced worse outcomes, including iatrogenic harm in 36.7 percent of pediatric patients with intellectual disabilities and high levels of preventable hospital readmission rates.²² Similarly, a chart review in the United States published in 2002 found that approximately one in three patients with a developmental disability received medication (often psychotropic drugs) that was not based on any prior diagnosis.²³ Despite the salience of this issue to patients, policy makers, caregivers, and advocates, there have been few attempts to systematically assess the experiences and outcomes of people with developmental disability.²¹

“One example of such an attempt is the 2021 Learning from Lives and Deaths (LeDeR) program in England²⁴ (formerly the Learning from Deaths Review Programme, established in 2015), which was set up to assess the circumstances surrounding the death of people with ‘learning disabilities’ (intellectual disability) and to derive lessons for future quality improvement.²⁵ This program evolved in response to awareness about the avoidable in-hospital deaths of six patients with developmental disability that were linked to poor clinical care.²⁶ Reviews conducted as part of LeDeR reported that as of 2018, approximately 13 percent of all deaths were caused by poor quality of hospital care, including negligence and abuse,²⁷ ultimately guiding the UK government objective to shift for patients with learning disability and autism from the in-hospital setting into the community.²⁸ However, more than half of these reviews have been a result of notification by family members, instead of being flagged by health care providers or allied health professionals.²⁴ A data-driven approach to systematically monitoring outcomes for patients with developmental disability could therefore enhance the identification of hospital failures, although the efficacy of routinely collected patient-level hospital data for such purposes in patients with developmental disability remains unknown.”

Source: Rocco Friebel and Laia Maynou. Assessing The Dangers Of A Hospital Stay For Patients With Developmental Disability In England, 2017–19. Health Affairs 2022 41:10, 1486-1495

“Whilst it is assumed that health services are intended to support the most vulnerable patient groups, this study illustrates that access to services is complex and may not always be compatible with this aim. In the first dimension of Levesque’s framework, patients’ ability to perceive care was constrained by their levels of health literacy and beliefs related to health and illness. Even when an MUR [Medicines Use Review] was undertaken, they were unable to fully benefit because they were unaccustomed, and therefore unprepared, to receiving such a service. In effect, patients had low ability to frame MURs as a service that they could access for support and could personally benefit from. This is unsurprising given our previous work suggesting there is a general plurality and fragility of patients’ sense-making of new pharmacists’ roles and services [38]. Similar problems of low ability to perceive have been seen in other services such as smoking cessation. Whereas interventions combining pharmacotherapy and behavioral support have been shown to increase successful attempts to quit smoking [39], it is acknowledged that people from marginalized groups (who have high prevalence of smoking compared with the general population) have lower levels of risk perceptions, poorer awareness and uptake of cessation support and poorer experiences (i.e., feel judged) [40,41,42].

“In the second dimension, it was found that patients’ capacity to choose to seek care was constrained by their knowledge of the MUR service, but also wider perceptions and experiences of healthcare and interactions with health professionals. Our findings support evidence suggesting that patients’ experience of healthcare is poor and subject to implicit bias [7,8,9,10]. The third dimension illustrated the problems patients encountered accessing care largely due their circumstance. Patients were particularly disadvantaged where they were physically unable to reach the pharmacy and so had fewer opportunities to speak to the pharmacist. In the final dimension, ‘ability to engage’, the impact of receiving a single MUR on the patient’s care and wellbeing was difficult to assess. Nevertheless, where the pharmacist’s advice and support were in line with patient expectations, this was valued by patients and reportedly made a positive contribution to their care.”

Source: Latif, A., Mandane, B., Ali, A., Ghumra, S., & Gulzar, N. (2020). A Qualitative Exploration to Understand Access to Pharmacy Medication Reviews: Views from Marginalized Patient Groups. Pharmacy (Basel, Switzerland), 8(2), 73. doi.org/10.3390/pharmacy8020073

“The repercussions on the provision of pharmacy service, management and delivery are unclear. Pharmacists are increasingly taking on enhanced medicine management and support roles to improve knowledge, understanding and adherence to medicines [16]. One example is of the UK National Health Service (NHS) community pharmacy funded medication review service known as ‘Medicines Use Reviews’ (MURs). Available since 2005, the service consists of an annual consultation with the pharmacist. The purpose being to resolve medicine related issues, concerns and to reduce avoidable waste [17]. Despite this service seeking to improve knowledge and use of medicines, significant variability in delivery has raised concerns, particularly that the service is not being targeted to patients who may benefit most from a review with a pharmacist [18]. There are low levels of evidence to support medication reviews for marginalized groups. However, this should not be interpreted as a lack of need, but rather a result of a general low level of representation of marginalized groups in research [19].”

UK: People with Disabilities - National Health Service NHS - National Policies - World Health Systems Facts

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Page last updated August 7, 2025 by Doug McVay, Editor.