This briefing looks at the challenges facing disabled people and sets out options in the form of a new toolkit for councils to consider. It highlights the poverty and additional cost of living challenges faced and the wider challenges for the UK’s 14.6million disabled people.
Briefing in full
The growing disabled community:
- 14.6 million people in the UK had a disability in 2020/2021.
- This is 22% of the population in 2020/2021.
- 9 million are of working age.
- Since 2002/2003 people reporting a disability has increased by 3.8 million (a 35% rise);
- Disability levels rise with age.
- Mobility is the most reported impairment (46%).
- In November 2021 there were 5.7 million people claiming an extra cost disability benefit. This was 8.7% of the total population.
- There is no national register of disabled people. Some local authorities operate voluntary lists.
Disability and poverty
Poverty rates are higher among families where at least one member is disabled, compared to families where no one is disabled.
According to a House of Commons report of April 2022. “In 2019/20:
- The proportion of people in relative low income before housing costs (BHC) was 23% for families where someone is disabled, compared to 15% for people living in families where no one is disabled.
- The rate of relative low income after housing costs (AHC) was 27% for families where someone is disabled, compared to 19% for those where no one is disabled. People living in families where someone is disabled comprised around 44% of the population in relative low-income BHC and 42% AHC in 2018/19. This compares to 34% of people across the total UK population living in families where someone is disabled”.
Overall, levels of relative low income have been fairly steady over the past few years, but this varies between population groups: the proportion of children and pensioners in relative low income is higher than it was five years ago. The share of people in absolute low income has also remained reasonably stable over the last five years. This indicates that both living standards for the poorest households and the gap between them, and middle-income households have remained about the same.
“Around one in four working-age disabled people in the UK struggle to pay for essentials like food and heating, as their budgets get stretched to breaking point.” (April 2022)
From Poverty to Destitution
The Joseph Rowntree Foundation (JRF) published, in July 2022, a report ‘From ‘Disability to Destitution’ highlighting the scale of poverty facing disabled people. It says:
“The official story on poverty among disabled people is bad enough. But new JRF analysis reveals that when it comes to real essentials of life, like heating and food, the problem is far worse than acknowledged in Whitehall.”
What is Deep Poverty?
People are in deep poverty if their income is below 40% of median income after housing costs. The Office of National Statistics in March 2022 said that the median income is £31,400. 40% would be £12,560 after housing costs. The median income is the income amount that divides a population into two equal groups, half having an income above that amount, and half having an income below that amount. The number of families with a disabled person in deep poverty has increased by a third or 2.3 million people.
The challenge of poverty facing disabled people is reinforced by the Institute for Fiscal Studies (IFS) report published on 6 July 2022 entitled ‘Living Standards of working-age disability benefits recipients in the UK.’
“People on disability benefits have much higher rates of relative income poverty than working-age adults in general (29% versus 20% in 2019–20). However, this measure of poverty does not take into account the fact that those on disability benefits likely have higher costs of living due to disability. Thus, this gap understates the true difference in the rate of low living standards.”
“There are around a million people who are disabled and in the most materially deprived tenth of the population but not receiving disability benefits. Out of the most deprived 10% of the working-age population, almost a third (31%) are disabled but not in receipt of a disability benefit. This could be down to ineligibility (perhaps because their condition is not severe enough to entitle them) or to eligible people not claiming the benefit (perhaps because they do not know they are eligible or find the assessment process too complex or unappealing).”
The range of challenges facing disabled people in poverty
There are a range of well-documented challenges facing disabled people that can, in part, be addressed by local councils and their partners:
- Higher costs of living
The extra cost of being disabled is stark. Life costs more for disabled people and their families, spending more on essential goods and services such as; heating, insurance, equipment and therapies. These extra costs mean disabled people have less money in their pocket than non-disabled people, or go without.
The result is that disabled people are more likely to have a lower standard of living, even when they earn the same. Disability charity Scope estimates the extra costs of being disabled are £583 per month on average. The Disability Price Tag report in 2019 revealed the extra costs faced by disabled people and families with disabled children.
- Food poverty
4.7 million adults have experienced food poverty according to the Food Foundation, based on a comprehensive survey in January 2022. This is 8.8% of households. Disabled people are five times more likely to be at risk of food insecurity compared to non-disabled people according to the research published by the Food Foundation.
The Office of National Statistics, on 5 August 2022, said that “Disabled people were more likely than non-disabled people to have reduced their spending on food and essentials because of their increased costs of living (42%, compared with 31%).”
- Housing access
Only 9% of homes in the UK are accessible for disabled people. This makes it more difficult for older and disabled people to remain in their own homes. Councils have long funded adaptations to properties to make them accessible.
The current UK Government has also increased funding for adaptations. On 29 July 2022 it announced a change in support to enhance measures to make housing more accessible. Councils need to make best use of the Disability Facilities Grant (DFG) funding.
- Housing costs
Poorer households tend to spend a higher share of their income on housing costs than people with higher income. According to the JRF report on poverty in 2019/20, there are four million people with disabilities in poverty, with seven million people in poverty either a disabled person or living with a disabled person. High housing costs, especially private rented housing and specialist housing costs, make the financial position of disabled people even more challenging, alongside other additional costs of living.
According to the UK Disability Statistics, published by the House of Commons library on 29 July 2022, the proportion of disabled people in work is 53.8%. This compares to 82% of non-disabled people. This means that 42.4% of disabled people are economically inactive, compared to only 15.4% of non-disabled people.
- Heath and Social care
The Kings Fund, in July 2022. published: ‘Towards a new partnership between disabled people and health and care services’, which highlighted that:
- 60% of those who died in the first year of the Covid-19 pandemic were disabled.
- Health and care services need to understand the broad diversity of disabled peoples’ identities and experiences, and adopt a social model approach to disability, understanding that people are disabled by barriers in society, rather than by impairments or health conditions.
- Heath and care staff need to value disabled peoples’ experiences.
At the heart of how health and social care services meet the needs of disabled people is the proposition that services will be better and more focused on people’s needs if engagement with disabled people is at the heart of all strategies, support and service development.
It will be important that disabled peoples voices are heard in the new Integrated Care systems (ICS) that seek to enhance partnership working. The Kings Fund in May 2022 set out how ICS will work.
Four guiding principles
The disability movement has embraced four key principles. These are central to local authorities developing their strategic and operational policies and practices in creating a partnership with disabled people:
- Social Model of Disability.
- Independent Living.
- Tackling Income inequality.
Social Model of Disability
Disability was seen as a medical problem that needed resolving, be that a wheelchair or being de facto imprisoned in an institution. The Social Model of Disability emerged as an alternative view. It is based on the assumption that disabled people have the same rights as other citizens and that disabled people need to be empowered to live full lives.
The social model of disability contends that people with impairments are ‘disabled’ by the barriers operating in society that exclude and discriminate against them. So the social model of disability highlights that the way society operates creates barriers for disabled people. The main barriers are:
- Attitudinal Barriers.
- Physical Barriers.
- Information and communication.
Independent living is not a new idea, but it does challenge the fundamental way in which people live and have access to services as they age or manage a disability. It is an alternative to institutional forms of care and to the over-reliance on hospital treatment. One of the big challenges facing an over-stretched, under-resourced NHS is the use of hospital beds for older people who would be better living back in the community. This, however, requires post-hospital support if a person returns home. Many NHS providers have post-hospital arrangements to move older and disabled people into the privately provided care home sector. Independent living is an alternative to care home provision.
There is huge commercial pressure to make use of care homes as an alternative to remaining independent in the community where a person has generally lived for many years.
Independent living should be advocated and supported by appropriate local authorities. There will be people requiring care home provision, but the provision of care and support should not be driven by commissioning processes that favour private provision rather than community-based independent living. There are 12 pillars of independent living:
- Appropriate and accessible information;
- An adequate income;
- Appropriate and accessible health and social care provisions;
- A fully-accessible transport system;
- Full access to the environment;
- Adequate provision of technical aids and equipment;
- Availability of accessible and adapted housing;
- Adequate provision of personal assistance;
- Availability of inclusive education and training;
- Equal opportunities for employment;
- Availability of independent advocacy and self- advocacy;
- Availability of peer counselling.
Local authorities should embrace this approach but it requires a closer integration between health, care and housing services. It also requires a change in ‘mindset’. There needs to be shift from a provision and commissioning mindset to an empowerment and co-production approach.
Tackling Income Inequality
The House of Commons, in November 2021, published a report entitled ‘Income inequality in the UK.’ It highlighted that: “Families where a member is disabled have significantly lower median incomes than families where nobody is disabled.”
The Office for National Statistics published in March 2022 data that confirms the pay gap or inequality facing disabled people:
“The disability pay gap, the gap between median pay for disabled employees and non-disabled employees, was 13.8% in 2021 and 14.1% in 2019 prior to the coronavirus (COVID-19) pandemic; this gap has widened slightly since 2014 when disabled employees earnt 11.7% less than non-disabled employees. The disability pay gap has consistently been wider for disabled men than for disabled women; in 2021 median pay for disabled men was 12.4% less than non-disabled men, and median pay for disabled women was 10.5% less than non-disabled women.”
The Kings Fund, in partnership with Disability Rights UK, published a report in July 2022 entitled ‘Towards a new partnership between disabled people and health and care services: Getting our voices heard.’
It highlights the inequalities experienced by disabled people. Disabled people are more likely to live in poverty, have less access to education and employment and experience poorer ratings of personal wellbeing compared with non-disabled people: “Disabled people are among those who have been worst affected by a decade of austerity and major reforms to the welfare system, which have increased the risk of poverty and, in turn, affected people’s health.”
Reflecting the ‘Nothing about us, without us’ strap line the report further argues: “Key to this involvement is health and care services understanding and valuing the expertise of people with lived experience.”
Disabled people should be central to all service provision relating to meeting their needs. This point was previously highlighted in the Scope charity research report of 2018. It further highlighted that whilst valuing support from social care, “There is a huge funding gap in social care, which is set to grow unless there is urgent action by the Government, and there is growing evidence that this is placing a strain on services offered to disabled people.”
Developing the technology and digital infrastructure
Central to supporting independent living, whether it’s people residing in their own homes in the community or in specialist or supported housing, is the creation of technology and digital infrastructures. The term ‘digital services’ refers to the electronic delivery of information, including data and other content, across multiple platforms and devices, such as computers and mobile phones. Some digital services have long been a feature of a range of housing options for disabled people: community alarm services are a good example.
The TAPPI Inquiry Report (October 2021) described digital technologies as “anything from devices and apps to modern smart appliances and internet connections and connected homes.”
Digital development has the potential to help local authorities, with some upfront investment, to reduce reliance on costly care options or to stop people becoming reliant on NHS services. It should be seen as key to independent living and care and support.
A new disability toolkit for local government
In October 2018 the Equality and Human Rights Commission published, with Habinteg, a toolkit for local authorities in England. Its focus was primarily on housing.
This briefing highlights an enhanced toolkit that local authorities could adopt in order to support and empower disabled people, helping them to live full independent lives. The measures in the toolkit would support disabled people in dealing with the current cost of living crisis, the extra costs of being disabled and the importance of empowering disabled people.
Measure 1: Council wide audit of Disabled people
Councils should carry out a regular ‘Disabled persons’ audit of their area. It would cover local information on accessible buildings, on health, care and housing opportunities; support services and employment options. It could then be updated every three years.
Measure 2: Local register of Disabled people
Some local authorities keep registers of disabled people in their area. Under Section 29 of the National Assistance Act 1948 local authorities may compile and maintain a register of disabled persons in order to ensure that local services can be tailored to meet their needs. Registration is voluntary and registration does not automatically entitle a person to any benefits or support – this would be dependent on a separate assessment of the person’s needs and, in some cases, their resources. In addition, section 77 of the Care Act 2014 provides that a local authority may establish and maintain one or more registers of adults in their area. Having a local register would allow disabled people to be supported and ensure a better on-going dialogue.
Measure 3: Digital modernisation strategy
Councils should develop local digital strategies to guide the promotion of independent living. This would allow disabled people to stay in their own homes and allow for effective communications to ensure safety and communications. It would help ensure fewer older and disabled people were in scarce hospital beds. But it needs to sit alongside other practical measures such as adapted homes and access to care services.
Measure 4: Staff training programme
All staff should undertake disability equality training, allowing both service delivery and strategic planning to reflect the challenges facing disabled people.
Measure 5: Disabled persons housing strategy
Councils should develop local housing strategies. These would guide housing strategy and Local Plans. Disabled strategies for persons housing strategies should be drawn up by disabled service users. Adopting co-production empowers, as well as leads to, better people-focused strategy, policies and services.
Measure 6: Local Support and advice
Every council should ensure disabled people have access to independent advice. Funding such advice should be a priority. Disabled people may want to define how that advice is provided. Disabled Peoples Organisations run by disabled people would be the favoured option of disabled people. But Citizens Advice or Law centres are other options. Councils need to ensure that the UK Government’s £421m Housing Support Fund is well targeted at the disabled people struggling most with the energy and cost of living crisis. It is unlikely to be enough and other intervention measures by the government will be required. However councils should be clear about the priorities for supporting disabled people locally.
Measure 7: Creating opportunities to work
Councils should work with disabled people to access the workplace. This means developing links with employers as well as disabled people.
Measure 8: Disabled people at the core of planning processes
The planning of communities, both housing provision and the built environment require input from disabled people. Councils could commit, as part of any planning process, to involve and engage with disabled people and their organisations.
Measure 9: Disabled people and Integrated Care Systems
The introduction of Integrated Care Systems from July 2022 raises major challenges and opportunities. It aims to bring together health and social care services through partnership arrangements. There is a strong case for disabled people to be part of the new partnership arrangements.
Measure 10: Disabled people: A priority for home insulation.
Disabled people are amongst the hardest hit by the energy crisis. The need to insulate homes and to reduce energy costs is essential. Starting with disabled people’s homes, and making disabled people’s homes more accessible, would be further measures to enhance independent living.
Disabled people are making up an increasing number of households in the UK, especially as the population ages. Too many disabled people live in poverty. The energy and cost of living crisis is hitting all low-income households hard, but may be hitting disabled people disproportionately more than other low-income households.
Local authorities are at the forefront of addressing the needs of the most vulnerable in our communities and disabled people on low incomes are probably the most vulnerable people in our communities. The adoption of this toolkit of 10 measures should help councils support some of the poorest residents in their communities.