- PIP claims among 16 and 17-year-olds with ADHD and autism more than tripled in England’s least deprived neighbourhoods between 2019 and 2025.
- The highest rates are still found in some of the most deprived areas.
- Diagnosis, ethnicity and access to the benefits system could help explain the changing pattern.
The number of teenagers receiving Personal Independence Payment (PIP) for ADHD and autism has risen sharply across England, but the fastest growth is no longer coming from the areas with the highest levels of deprivation.
A new analysis by the Nuffield Trust found that the proportion of 16 and 17-year-olds receiving PIP for the two conditions in the least deprived fifth of neighbourhoods more than tripled from 0.8 per cent in 2019 to 2.5 per cent in 2025. Across England as a whole, the rate increased from 1.3 per cent to 3.4 per cent over the same period.
PIP is a benefit for people with long-term health conditions or disabilities who face extra costs or difficulties with everyday activities. It is not means-tested, so household income does not determine eligibility.
The change does not mean that wealthier areas now have the highest rates. They do not. In the most deprived fifth of neighbourhoods, the proportion of 16 and 17-year-olds receiving PIP for ADHD or autism rose from 2.1 per cent in 2019 to 5.1 per cent in 2025.
But the gap has narrowed. In 2019, the rate in the most deprived areas was around 2.5 times that of the least deprived areas. By 2025, it was about twice as high. The Nuffield Trust found that the faster increase in the least deprived areas was statistically significant.
The postcode picture is becoming harder to explain
Some of the sharpest increases can be seen in areas that would not traditionally be associated with high levels of disability benefit claims.
In Runnymede, Surrey, the proportion of 16 and 17-year-olds receiving PIP for ADHD or autism rose from around one in 58 in 2019 to one in 19 in 2025. Bracknell Forest in Berkshire saw a rise from roughly one in 89 to one in 20.
At the same time, the highest rates remained in some of England’s most deprived areas. In Liverpool and Knowsley, around one in 12 teenagers in the age group were receiving PIP for ADHD or autism in 2025, compared with about one in 35 and one in 57 respectively six years earlier.
The Nuffield Trust said the weakening relationship between deprivation and PIP rates appears to be particularly associated with ADHD and autism. For other disabilities among 16 and 17-year-olds, the traditional deprivation pattern has actually become stronger.
That raises a difficult question about what the PIP figures are measuring.
PIP is intended to reflect the effect a condition has on a person's daily life rather than simply whether they have a diagnosis. Yet the analysis found that areas with relatively strong employment and educational outcomes have experienced some of the fastest increases in claims for ADHD and autism.
Sally Gainsbury, senior policy analyst at the Nuffield Trust, said the figures could reflect differences in access to diagnosis, while also pointing to uncertainty around how disability is assessed and understood.
“PIP is meant to reflect how much a condition affects someone’s day-to-day life, rather than purely whether they have a diagnosis,” she said, adding that it was “intriguing” to see recipient rates growing most rapidly in areas where employment and education outcomes were relatively strong.
The analysis also found an association between the proportion of residents identifying as White and PIP rates for ADHD and autism. The Nuffield Trust said this could help explain lower-than-expected rates in some ethnically diverse areas, including Newham, Brent, Leicester, Bradford and Wolverhampton.
The finding does not establish that ethnicity itself causes differences in PIP claims. The think tank said it could point towards barriers to diagnosis or accessing benefits, as well as cultural differences in how symptoms and disability are recognised.
A £296m benefits bill and a bigger question
The rise in claims has also changed the amount of money flowing through the system.
An estimated £296 million was spent on PIP for 16 and 17-year-olds with ADHD and autism in 2025. Around £87m of that went to young people living in the 40 per cent least deprived neighbourhoods.
That was almost four times the £22m spent in those areas in 2019, after adjusting for inflation.
Across England, 51,148 16 and 17-year-olds were receiving PIP for ADHD or autism in 2025, compared with 16,045 in 2019.
The Nuffield Trust has pointed to several possible explanations for the changing pattern. These include the cost-of-living pressures that may have encouraged more eligible families to claim support, differences in how local deprivation is measured, unequal access to diagnosis and possible inconsistencies in PIP assessments.
It also notes that a diagnosis is generally needed to pursue a PIP claim, potentially creating another layer of inequality between people who can access assessment and those who cannot. Research cited by the think tank has found higher rates of new ADHD diagnoses in less deprived areas, with greater use of private routes to diagnosis among more affluent groups suggested as one possible factor.
The figures therefore offer only a partial picture of need. The Nuffield Trust cautioned that administrative data can show who is receiving recognised support, but cannot establish the full distribution of disability across the population.
That distinction is becoming increasingly important as demand for ADHD and autism assessments continues to put pressure on health services.
The government-commissioned independent review into mental health conditions, ADHD and autism is examining the reasons behind rising diagnosis and service demand. Its interim report said recorded diagnoses, referrals and self-identification have increased substantially, while some population-based estimates of underlying prevalence appear more stable. The review said its final report will consider what needs to change in how people receive support.
For policymakers, the growing PIP bill may therefore be only part of the question. The harder issue could be working out whether the changing geography of claims reflects changing levels of disability, greater recognition of previously unmet needs, easier access to diagnosis and benefits, or several of these factors at once.
