This Budget reports that 5.2 million additional appointments have been delivered since the start of this parliament, but the waiting list has not fallen at the same pace as the rise in appointments. 

Reducing waiting lists further therefore remains a top priority for the government, with increased NHS funding presented as a key driver of future improvements. 

For people with IMDs, shorter waits could mean faster diagnosis, where diagnosis is available, or quicker access to specialist clinics, dietetic support, investigations, and follow up care. However, it was not made clear where in the NHS system these additional appointments had been delivered. 

The full impact for people living with an IMD will depend on whether waiting list work reaches specialist and regional metabolic services as well as larger hospital backlogs. 

This Budget links NHS reform to the NHS 10-year health plan published in July 2025. 

When the plan was published, it was not clear how it would be implemented, as it did not include a delivery chapter or a clear funding route. This Budget provides some insight into how aspects of the plan may be funded. 

As discussed earlier this year, the plan contains very limited direct focus on rare conditions. Any benefits for IMDs will depend on how well general reforms work for lifelong, complex conditions. 

The Budget commits an additional £300 million to NHS technology aimed at improving productivity and patient access. 

Priorities include improved communication between primary and secondary care, stronger NHS App functionality, and closing gaps in access to digital health records so patients can make informed decisions about their care. 

For IMD families, better shared digital records could reduce repeated history taking, missed details about emergency protocols, and errors in dietary or medication plans when care is split across multiple hospitals. While this investment is welcome, funding alone may not be enough. Full improvement will also rely on effective system use and wider change. 

The Budget sets out several ways the NHS will save money through improved efficiency and productivity and commits to retaining and reinvesting these savings back into care. 

One way savings will be delivered is through the abolition of NHS England to reduce duplication and bureaucracy. NHS England currently leads and oversees the NHS in England, setting priorities and standards, allocating much of the NHS budget, and commissioning some highly specialised services. These responsibilities will move to the Department of Health and Social Care. 

While this change is estimated to save £1 billion per year, structural reform can create uncertainty for rare disease services unless specialist commissioning, workforce planning, and existing rare disease commitments are protected during the transition. This is particularly important with the Rare Disease

The government has confirmed it will not proceed with the Spring Statement 2025 reforms to PIP eligibility, and PIP award review periods will be extended. For IMD claimants, longer award periods may reduce the stress of frequent reassessments, particularly for those with long term conditions that are unlikely to improve. 

A wider review of the PIP system is also due to be launched. This review will be fully co-produced with disabled people to ensure that any changes reflect lived experience and that the system is fit for the future. 

As the review has not yet begun, its outcomes are unclear. Longer term changes remain possible and will need monitoring. 

The government plans to increase the use of face-to-face health assessments for people claiming health related benefits, mainly PIP, Work Capability Assessments for Universal Credit, and Employment and Support Allowance. 

It has also committed funding for 122,000 additional work capability assessments for existing claimants, with the aim of ensuring people receive the correct level of support. 

While these changes may improve accuracy for some claimants, they could also increase stress and travel demands. How assessments are delivered will be particularly important for IMD families managing fatigue, hospital appointments, or mental health pressures. 

 The additional Universal Credit amount paid because of illness or disability will be reduced for most people who newly qualify after 6 April 2026. It will fall from around £97 a week to about £50 a week, then remain frozen at that lower level until 2029 to 30. Existing claimants will keep the higher rate, although it will be frozen in cash terms. 

The government has stated that people who meet severe conditions criteria will have their combined UC support protected in real terms. 

This is particularly relevant for IMD households where illness limits work, especially for young adults moving onto benefits for the first time. The detail of how severe conditions are assessed will matter in practice, particularly for fluctuating conditions, which may apply to many IMDs. 

The Budget sets aside £1.5 billion for employment and skills support for disabled people and those with health conditions, linked to the Keep Britain Working review.

The Pathways to Work Guarantee will offer specialist work coaches and tailored support for people with health conditions who are currently out of work, alongside the Connect to Work programme. 

For people with IMDs who are able, this support could be helpful if it is flexible and recognises fluctuating health, complex care routines, and the need for reasonable workplace adjustments. 

These cost of living measures are not specific to IMDs, but they may still affect families living with and caring for someone with an IMD by shaping household budgets and day to day pressures. 

• The two-childbenefit cap will be abolished from 2026, supporting larger families including those with more than one affected child or young carers.
• Household energy bills are expected to fall by around £150 a year from April 2026 due to changes in how green levies are funded. This may help families with higher energy use linked to care needs.
• Income tax thresholds are frozen until 2031, which over time may pull more households into higher tax bands and reduce disposable income.
• A one year freeze on NHS prescription charges in England will apply from 1 April 2026, helping households that rely on regular, paid for prescriptions. 

From April 2028, central government will take full responsibility for SEND funding in England, rather than local councils. 

The government presents this change to stabilise funding and improve consistency. 

Many children and young people with IMDs rely on Education, Health and Care Plans and SEND provision. The key issue will be whether this reform reduces the post code lottery and assessment delays without tightening eligibility or reducing flexibility for complex needs. 

A SEND white paper is due for consultation in the new year and may provide further clarity. This will continue to be monitored.