Access to quick and sufficient financial support can mean the difference between a dignified end-of-life and significant hardship for terminally ill people. However, recent UK government welfare reforms propose big changes to disability benefits, notably Personal Independence Payment (PIP), with tougher rules aimed at reducing welfare spending by around £5 billion annually by 2030. But what does this mean for terminally ill people in Scotland?
In England and Wales, terminally ill people qualify for enhanced Personal Independence Payment rates if they are expected to have twelve months or less to live, as assessed by a health professional. In Scotland, Personal Independence Payment was replaced by Adult Disability payment (ADP). People in Scotland qualify for enhanced Adult Disability Payment rates if they have a progressive disease from which death may reasonably be expected, meaning people qualify for enhanced daily living and mobility payments.
The Scottish Government says it wants a benefits system with more dignity for claimants and fewer intrusive assessments. A key part of Scotland’s approach is the Benefits Assessment Under Special Rules in Scotland (BASRiS). Under BASRiS, a registered medical professional can confirm a patient’s terminal diagnosis using a short form, which is then sent to Social Security Scotland. This process is designed to speed up claims and ensure terminally ill individuals receive the maximum level of financial assistance with minimal delay.
The draft Scottish Palliative Care Strategy (2025–2030) sees the BASRiS as critical, stating:
“BASRiS is the only supporting information required when someone is applying for disability benefits under the special rules.”
Findings from our Dying in the Margins study showed how financial insecurity significantly exacerbates the practical and emotional stresses experienced at the end of life. Financial hardship restricts individuals’ ability to maintain basic comfort at home, especially by limiting heating and electricity usage—essential for managing symptoms or operating medical equipment like ventilators or mobility aids. It also curtails access to necessary medical care, as transport costs to hospitals or clinics become too expensive, forcing people to endure long, uncomfortable journeys on public transport, causing more pain and distress.
Building on these findings, Scottish data from the Marie Curie-funded Unreached study, which explores financial insecurity among terminally ill individuals in rural areas, highlights how important financial help can be when received quickly. One study participant said:
“Unlike the PIP rules, I am classed under the ADP rules as having a terminal illness… I went to my GP… and sure enough, I got it. So that uplift made all the difference to me.”
Funding Challenges
UK-level reforms to Personal Independence Payment stand to affect Scottish Government finances. Scotland’s disability benefit funding is tied to Westminster’s spending through the Block Grant Adjustment (BGA), so any reduction in spending on Personal Independence Payment in England and Wales would reduce Scotland’s funding proportionally. The Scottish Fiscal Commission forecasts a potential funding shortfall, which will increase if Personal Independence Payment spending falls significantly south of the border.
The Scottish Cabinet Secretary for Social Justice, Shirley-Anne Somerville, has promised to keep current Adult Disability Payment levels and rules, stating that the Scottish Government would manage any funding gaps without cutting support for disabled people.
However, how this will be achieved remains to be seen, and reduced funding could force Scotland into taking tough decisions regarding disability benefits. Reduced financial support through the block grant risks placing more financial and emotional strain on carers and terminally ill individuals who rely on these supports.
