Changes to Welfare and The Spring Statement – What does it mean for people with brain injury?

There have been a number of announcements from the government in recent weeks, with many potential changes coming up that may impact those living with brain injury. Our Policy Officer, Thea Arch, breaks down these announcements and their possible implications. 

Welfare

The government is proposing £4.8bn worth of welfare cuts, aimed at ‘getting people into work’. This includes tightening eligibility for Personal Independence Payments (PIP) and scrapping the Work Capability Assessments (WCA), in favour of a single assessment via PIP. This assessment will determine whether a person receives extra financial support for health conditions within Universal Credit (UC).  

These plans were published in their Green Paper titled: Pathways to Work: Reforming Benefits and Support to Get Britain Working Green Paper – GOV.UK 

How will it affect Universal Credit? 

• The top rate of Universal Credit for those who receive the most support will be cut, but the standard rate will rise above inflation for the first time, reaching a £775 annual increase per person by 2029-30. 

• The Health Element top-up will be denied to under-22s, with a view to reinvest the money saved ‘into training for young people’. 

• The top-up will also be cut for new claimants – from £97 to £50 per week by 2026/27 – a cut of more than £2,000 a year – and frozen for existing ones. 

How will it affect Personal Independence Payments? 

• The government has also proposed changes to the criteria for assessing PIP. 

• The new PIP eligibility requirement would ensure that only those who score a minimum of 4 points in at least one daily living activity will be eligible for the daily living component of PIP. 

• This means that people scoring 3 or less for each activity will no longer be eligible for the daily living component of PIP. 

• This means that, for example, you would not qualify even if you required all of the following: assistance to dress your lower body, supervision to manage toilet needs, assistance to wash below the waist, need prompting or assistance to be able to make complex budgeting decisions, read or understand complex information. 

• The government wants more frequent reassessments for many people claiming PIP, with more face-to-face assessments. 

The Spring Statement

The Statement confirmed the proposed changes set out in the Green Paper. It included an equality analysis estimating that 96% of families who will financially lose out from the reforms will be those who have a family member with a disability.  

The Department for Work and Pensions also estimates that the tightening of the Personal Independence Payment (PIP) criteria will result in 150,000 missing out on receiving Carer’s Allowance or the Universal Credit Carer Element. 

How might these changes impact those living with brain injury?  

Benefits like PIP and UC provide crucial financial support to help with the extra costs associated with brain injury, as well as supporting those who cannot work. Tightening the eligibility criteria for these benefits will most likely have a negative impact for many people, as acquired brain injury (ABI) can often manifest in ways that may not be obvious or easily captured in a structured assessment.   

Impacts such as difficulties with regulating mood, maintaining social relationships, sensitivities to light and sound, and problems with executive function, may all affect someone’s day to day life and capacity to work, but may not be reflected in the ‘daily living’ activities section in the PIP assessment.  

In addition, assessments like these can be particularly misleading or misrepresented for those living with brain injury due to a phenomenon named ‘the ‘frontal lobe paradox’.  

This means someone with brain injury can often have difficulties in everyday life, such as problems with decision-making, multitasking and goal setting, yet continue to perform well in interview, self-report and test settings for a number of reasons, such as preserved language and communication skills or lack of insight.  

As Senior Research Fellow at Brainkind, Dr Sara Da Silva Ramos explains: ‘We know that relying on self-assessment, self-report, or even an assessment in a structured environment, rather than observation of ability to carry out these tasks in a day-to-day setting, may overestimate how independent a person with ABI can be.’

Sara also pointed out problems with the new proposed assessment criteria: “For example, if you need prompting to be able to cook a simple meal, the score is 2. If you need supervision or assistance, you score 4. Problems with initiation mean that some people with ABI may need that prompt to get started, in several different areas, but not assistance throughout. However, without that prompt, the task would not have been completed.

“This could mean that people might not reach the score of 4 in multiple areas. The medication or managing health conditions criteria is based on time. However, some people may need prompting to take lifesaving medication (e.g. anti-epileptic, insulin), but that may not take more than 3.5 hours a week…”

There are also significant issues with removing the health benefit for under-22s. A brain injury can happen to anyone, at any time, and may require support at any age. In addition, young people living with an ABI already contend with very limited rehabilitation services. Together with the expectation that they return to work or education, without the accompanying vocational rehabilitation services to enable them to do so, this will be particularly challenging.   

‘Times in rehabilitation have shortened and shortened over the years,” continues Sara. “his means that often we [professionals] are no longer able to work with people with ABI and employers to support their return to work.  People are discharged too quickly.”

Jennifer Woodgate, Clinical Lead Physiotherapist at Brainkind, says people she supports are already very concerned about the proposed changes.  

“They are very scared and worried. …The process is already so difficult to navigate. It looks like there will be a significant drop in benefits that a lot of people are using to pay for physiotherapy and other support, so they are worried that this will stop. A lot of brain injury symptoms are not immediately obvious and can vary, so a face-to-face reassessment will be challenging and needs to be over time and not ‘in the moment’.”

Next steps

The government is consulting with people both inside and outside of Parliament on most of these changes before deciding which measures they will be taking forward. 

This consultation will be open until 11.59pm on 30 June 2025 and you can find the consultation survey here, as well as more information about the consultation, including accessible formats, here.  

Brainkind will be responding to the consultation to outline our grave concerns regarding the proposed cuts, and we will continue to work with government to advocate for all people living with brain injury, while providing the highest quality of  rehabilitation and care to ensure that as many people as possible have access to life-changing services.