From Proposals to Progress: Improving Lives for People with Learning Disabilities in Scotland

As we approach the end of the first year of our Leading Good Lives research programme, our third programme funded by Acorns to Trees focusing on the lives of people with learning disabilities, and with the Scottish Parliament election in May around the corner, a number of policy and evidence-related publications have been released.

With only one week remaining before the pre-election period began, the Scottish Government published its proposals for potential provisions of the Learning Disabilities, Autism and Neurodivergence (LDAN) Bill, alongside documents on costs, benefits and equality impacts. These offer a glimpse of how the ambitions discussed over recent years might translate into legislation.

These were swiftly followed by the publication of the Coming Home Action Plan 2026, which sets out progress to date, responds to the outstanding recommendations from the Coming Home Implementation report, and outlines further actions needed to deliver its overall vision.

The same week was concluded with the Scottish Parliament’s Equalities, Human Rights and Civil Justice Committee publishing a report on their inquiry into Neurodivergence in Scotland. The inquiry was launched following the Scottish Government’s decision in 2024 to delay the introduction of the LDAN Bill.

Proposals for Potential LDAN Bill Provisions

In earlier blogs, we highlighted the broad direction of travel, with a Bill intended to improve coordination across services, strengthen accountability, and ultimately improve outcomes. Reflecting a key focus of our work, we also set out our thoughts on proposals around data.

The draft provisions begin to fill in some of the detail. There is an emphasis on enhanced planning, reporting, and improving how services work together. This reflects a commonly discussed concern that people’s experiences can often be shaped by fragmented rather than fully joined-up support.

There is also a continued focus on workforce and practice, including proposals for mandatory training for relevant staff across health, social care and justice services, as well as on ensuring more consistent standards of support through statutory duties, strategic planning, and enhanced oversight. None of this will be surprising to those who have followed the development of the Bill so far, but it does mark a shift from high-level ambition to something more tangible.

It will be for a future government to decide whether to take this work forward. With the Scottish Parliament election approaching, the proposals for potential Bill provisions published now will serve as groundwork for continuing the Bill’s development. The documents are intended to support further discussion and engagement, providing transparency about the current stage of policy development following the 2023–24 public consultation and the targeted engagement with the three Bill Advisory Panels throughout 2025. They do not, however, commit any future government to specific policy positions.

Data Improvement

One of our most consistent messages has been the importance of data. Put simply, it is near impossible to improve outcomes or effectively inform policy without reliable, consistent, and timely information. Data improvement remains a key component of the LDAN Bill proposals, with clear recognition that a strategic approach to data collection and reporting could strengthen evidence-based policymaking, support better service design and delivery, guide resource planning, and enable monitoring and evaluation of outcomes. The potential LDAN Bill aims to build on existing initiatives, including Scotland’s Health and Social Care Data Strategy, Public Health Scotland’s health and social care collections, and annual health checks for people with learning disabilities.

The draft provisions correctly state that neurodivergent people and people with learning disabilities remain under-represented in both quantitative and qualitative data. There is also an implicit recognition of challenges we have highlighted in previous reports and blogs. Current national data collections (such as those on prison populations, employability support, social security, the Scottish Household Survey, and the Scottish Crime and Justice Survey) take inconsistent approaches to neurodivergent people and people with learning disabilities and rarely provide the level of detail required.

The Bill proposes measures to address this, including a potential regulation-making power to define what data must be collected and reported by public bodies, a duty on Scottish Ministers to consult on these regulations, and a requirement to publish the information collected annually.

The proposals highlight scope for a new National Neurodivergence and Learning Disabilities Health and Social Care Statistical Report, which could capture health and social care outcomes and experiences. They also note that existing national data collections could include disaggregated and condition-specific data for neurodivergent people and people with learning disabilities, without requiring legislation.

For these reporting requirements to genuinely improve understanding and outcomes, it will be crucial to spell out exactly what data is collected, how it is standardised, and how different systems are linked. Without this level of detail, there is a risk that reporting duties become more about process than about genuinely improving the evidence base and understanding outcomes. The proposals note that achieving this would require a new national approach to local health and social care data collection, which the Bill could help deliver. As we highlighted during the LDAN Bill consultation, this must be supported by appropriate resourcing and expertise.

An Update on Annual Health Checks (*section added 2nd April 2026)

While the proposals for potential LDAN Bill provisions seek to improve data infrastructure and enhance collection and reporting, the latest annual health check figures provide one example of progress while highlighting where further work is needed.

The latest statistics on annual health checks for people aged 16 and over with a learning disability, published by the Scottish Government, cover the first half of 2025/26 (April to September). Across this period, 5,296 health checks were offered, with 3,567 completed and 1,757 resulting in an onward referral. These figures show that around two-thirds of offered checks were completed, with roughly half of those leading to an onward referral during the first six months of 2025/26.

However, unlike the previous full-year release, these figures are not broken down by NHS Board, making it difficult to assess variations in implementation or explore differences in models of delivery. They also do not update the number of people identified for an annual health check, a statistic included in the previous annual release.

Set against published 2024/25 data, these figures suggest a potentially encouraging trend. In the first half 2025/26, the number of health checks offered had already reached approximately 86% of the total delivered across all of 2024/25, with completed checks at around 92% of last year’s total. If this pace is maintained, it would represent a notable step forward in delivery.

Nevertheless, caution is still needed. Without more detailed breakdowns, particularly by NHS Board, it is difficult to know whether these figures reflect broad-based improvement or continued variation in how checks are delivered. That said, the publication is welcome, as relying solely on annual data limits our ability to track progress in a timely way. It would be valuable if the upcoming full-year release provided even more detailed breakdowns than last year, including information on the characteristics of people with learning disabilities, with future mid-year updates continuing to enhance transparency and support timely monitoring of progress.

Costs, Benefits and Equality

Alongside the draft provisions, the Scottish Government has also published a document on the costs and benefits of the proposed Bill, as well as a partial Equality Impact Assessment (EQIA).

As the costs and benefits considerations document sets out, the Bill aims to embed prevention, support early intervention, and create more efficient, sustainable services. If taken forward, it has the potential to deliver wide-ranging benefits, including improved wellbeing, more accessible and inclusive services, reduced inequalities, increased economic inclusion, and possible long-term savings.

However, there will be upfront costs associated with implementation. These include developing and monitoring strategies and plans, delivering mandatory training, enhancing data systems, and managing increased demand on advocacy and diagnostic services. This will require additional skilled workforce capacity and resources.

Should the next government decide to continue the Bill’s development, further research and detailed engagement with partners will be needed to better assess potential costs, benefits, impacts, and implementation options. If a future government chooses to introduce the LDAN Bill, a Financial Memorandum would set out in detail the expected costs, savings, and changes to revenue associated with the legislation.

The partial equality impact assessment highlights the wide range of inequalities experienced by people with learning disabilities and neurodivergent people, and the potential for the Bill to contribute to addressing these. It also points to gaps in evidence for some groups, which reinforces the need for more comprehensive and inclusive data collection.

Although the proposed Bill focuses on learning disabilities, autism, and neurodivergence, it will also be important to consider the implications for other disabled groups and to maintain attention to intersectional issues. The partial EQIA states that future development could include embedding intersectional data and analysis standards, reflecting diverse lived experiences in mandatory training, and strengthening co-production in statutory strategies. All of these measures are important steps, but their real value will depend on how effectively they are implemented and embedded in practice.

The Coming Home Action Plan 2026

Jointly owned by the Scottish Government and COSLA, the plan builds on the 2022 Coming Home Implementation Report and reflects work by the Short Life Working Group, established in July 2025 to address outstanding recommendations and set future priorities.

The Coming Home Action Plan 2026 provides progress on the long-standing effort to reduce inappropriate hospital stays and out-of-area placements for adults with learning disabilities and complex support needs. At its core, it aims to help people live well in their own communities rather than being delayed in hospital or placed far from home without choice. The new plan sets out 15 strategic aims and 34 actions to reduce delayed discharges, prevent inappropriate placements, and support stable community living. The plan will benefit from £20 million in funding, much of it via the Independent Living Fund Scotland. This brings total investment in the Coming Home agenda to £40 million since 2021.

We have discussed this topic in previous blogs, particularly regarding data from the Dynamic Support Register (DSR). The DSR is now used across all Health and Social Care Partnerships (HSCPs) in Scotland and remains a key tool in monitoring progress and guiding action. Strengthening the DSR is central to the plan, with improvements in data collection, analysis, and reporting, alongside closer liaison between Public Health Scotland and Coming Home leads. Changes to quarterly DSR publications in 2026-27 may include new data, revised schedules, and improved dissemination and quality assurance.

The plan also emphasises reducing unnecessary inpatient stays, particularly for people who have been in hospital for long periods, and reinvesting resources into community-based services. The National Support Panel will provide expert guidance, share best practice, and address complex cases that local systems cannot resolve. Housing, workforce development, and community services are key priorities. A new Housing Options Guide, training resources for social care staff, and collaborative commissioning aim to expand safe, independent living opportunities.

The latest data as at 25 December 2025 showed that 391 people were recorded in the urgent category of the Dynamic Support Register, including 176 in hospital (68 delayed discharges, with 28 individuals delayed for two or more years), 28 in inappropriate out-of-area placements, and 187 at risk of support breakdown. Although some progress has been made relative to the end of 2023, when DSR reporting was first introduced, these figures highlight that much work remains to ensure that adults with learning disabilities and complex needs receive timely, appropriate support in the settings that suit them best.

Neurodivergence in Scotland

Members of Holyrood’s Equalities, Human Rights and Civil Justice Committee have published a report emphasising that the challenges facing neurodivergent people in Scotland require urgent attention. Their decision to launch this inquiry followed the postponement of the Learning Disabilities, Autism and Neurodivergence Bill, a delay that raised serious concerns about whether the needs of neurodivergent people were being genuinely prioritised.

In the wake of this setback, the Committee undertook a series of formal and informal evidence sessions. What emerged was a consistent picture across education, employment and the criminal justice system, with neurodivergent people continuing to encounter barriers that are not only persistent but preventable.

A key theme running throughout the evidence was the stark gap between policy and practice. While frameworks and supports exist on paper, the lived experiences shared with the Committee suggest these are not being realised in meaningful or consistent ways. The Committee therefore emphasised that the next administration must engage directly with neurodivergent people to fully understand the scale of these disconnects, often described as implementation gaps, and how they can be addressed.

The Committee also acknowledged the growing demand on systems, with unprecedented numbers of people either receiving or seeking a neurodivergent diagnosis. Alongside this, significant concerns were raised once again about data. For example, there is a lack of robust information on the prevalence and experiences of neurodivergent people within the criminal justice system, from accused persons to victims and witnesses.

We were pleased to see evidence from the Fraser of Allander’s Chirsty McFadyen included as part of the report. Chirsty’s work, which focuses on employment, reflects a key strand of our Leading Good Lives programme. Drawing on Fraser of Allander research with employers both with and without experience of hiring someone with a learning disability, Chirsty highlighted a clear demand for practical guidance. Employers have consistently asked for case studies, whether delivered in person or online, to better understand what simple adjustments might look like in practice.

We have also heard that many employers are unsure where to find reliable information or how to get started. There is a sense that existing guidance is often not concrete or detailed enough to support confident implementation. As Chirsty noted, low levels of disclosure further complicate this, leaving employers without clear insight into what approaches are most effective. Embedding support into everyday systems could help address this, making it easier to identify what works in practice.

The report highlights the importance of continuing our work to better understand people’s experiences of trying to access and sustain work, as well as the challenges faced by employers in creating genuinely inclusive workplaces. This is central to making progress on the disability employment gap.

It is encouraging to see lived experience reflected throughout the report. More broadly, it underlines the importance of combining quantitative data with lived experience. Both are essential if policy is to be grounded in the realities of people’s lives and to drive more informed, practical action to improve employment opportunities across Scotland.

Looking Ahead

The path forward will require sustained focus on embedding inclusive practice across health, social care, education, justice and employment systems. Transparent and consistent data collection will remain central, supporting evidence-based decision making and the monitoring of outcomes. Equally important is meaningful engagement with neurodivergent people and those with learning disabilities, ensuring policies reflect real needs and lead to tangible improvements in everyday life.

For policymakers, this will mean balancing ambition with clear resourcing, robust data, effective implementation and accountable delivery. As the Scottish Parliament election approaches, the insights, proposals and evidence emerging from recent publications and the work that underpins them offer a strong foundation for shaping the next government’s priorities. The opportunity now is to turn proposals and policy ambition into real progress, creating systems, workplaces and communities where all people with learning disabilities and neurodivergent people can truly lead good lives.