Coming Home Action Plan 2026

2. Progress to Date

This section provides a summary of progress to date against the key Coming Home Implementation Plan recommendations.

Recommendation 1 – Scottish Government and COSLA should make a policy commitment to take forward the proposed framework.

The Scottish Government and COSLA jointly established a Senior Strategy Group to oversee the delivery of the recommendations in the Coming Home Implementation Report. The group took a collaborative, partnership approach which included the development and implementation of the Dynamic Support Register (DSR), the establishment of the Peer Support Network and early discussions on the shape of a National Support Panel (NSP). The group consisted of experts with lived experience (both family carers and people with learning disabilities) working with leaders from integration authorities, local authorities, NHS Boards and social care and support providers.

The Scottish Government has provided funding to support implementation and established the Dynamic Support Register. Consideration of the legislative framework required for the NSP is being addressed through the development of the Learning Disability, Autism and Neurodivergence (LDAN) Bill. COSLA too has played a key role in engaging with the Scottish Government, Health and Social Care Partnerships (HSCPs) and local authorities to support implementation.

To support local action, in 2021 the Scottish Government provided additional funding to integration authorities through the multi-year £20 million Community Living Change Fund (CLCF) and Coming Home budget. Combined with wider activity, this funding has supported real change for individuals who were at risk of placement breakdown, delayed in hospital or in inappropriate out-of-area placements. We are in the process of evaluating the final impact of the CLCF.

Recommendation 2 – The Dynamic Support Register should be developed into a tool for national use.

The Dynamic Support Register (DSR) was launched in May 2023, as one of the key recommendations from the Coming Home Implementation Report. The DSR was intended to support Coming Home by improving the visibility of people with learning disabilities and complex care needs at local and national levels, and as a tool to support local planning and decision making.

Detailed operational guidance was developed to support the use of the DSR, and a number of online events were held to inform the operational use of the DSR. The DSR was never intended to just be a list and, to ensure it was used in a proactive and dynamic way that results in real change for the individuals on it, a number of tools were developed to support its use. This included a procedure for Register Review Meetings, with meetings held regularly to review all those on the register and prioritise cases for action; and a Personal Action Plan to ensure the Register Review Meetings take a person-centred, problem-solving approach to actively support discharge or return home. The DSR is now being used in all HSCPs across Scotland.

National DSR data is collated and published quarterly by Public Health Scotland (PHS). PHS also publish more detailed reports once a year to enable enhanced tracking of numbers and progress. In terms of visibility and accountability this is a very positive development as, for the first time, Scotland now has a detailed overview both locally and nationally of people with learning disabilities and complex needs who are living in hospital, in inappropriate out-of-area settings or at risk of support breakdown due to issues with their existing community support.

As the DSR is a relatively new data collection,^[2] trends need to be interpreted with caution. However, the data suggests encouraging progress, with the most recent published data (as at December 2025) showing continuing improvement, with fewer people delayed in hospital and in inappropriate out-of-area placements compared to the previous year (December 2024).^[3] Importantly, there has also been a notable reduction in the number of people in hospital for 10 or more years over this period.^[4] The latest quarterly data from December 2025 reported that:

• 68 people were delayed in hospital, compared to 84 in December 2024
• 31 people had been in hospital for at least ten years, compared to 40 in December 2024
• 28 people were recorded as being inappropriately out-of-area, compared to 53 in December 2024
• 187 people were recorded as being at risk of support breakdown, compared to 227 in December 2024

A recent survey of Health and Social Care Partnerships, carried out by the Coming Home Short Life Working Group (described further in section 4 below) found that staff believed that the DSR had made a positive difference in improving visibility of those with learning disabilities and complex needs.

Although this progress is recent and needs ongoing work to ensure it is continued, it is still encouraging to note that the implementation work on Coming Home is beginning to show some positive outcomes for people with learning disabilities and their families.

Recommendation 3 – A National Support Panel should be established in order to provide support and oversight of the Dynamic Support Register

This recommendation proposed a NSP to:

• work with integration authorities and partner organisations by providing support and expertise for their decision making and solutions for individuals in a collaborative forum
• provide checks and balances to ensure that people with learning disabilities are receiving the best care in the most suitable environment
• understand and hear from families and individuals about their individual circumstances

It was recommended the Scottish Government should consult on the role and remit of the Panel. Its subsequent Consultation on the LDAN Bill set out three options around the scope and remit:

• Option A: Legislative Panel Conducting Individual Reviews within Defined Parameters
• Option B: Legislative Panel Conducting Peer Reviews of Local Processes
• Option C: Non-legislative Panel Conducting Peer Reviews of Local Processes

There was broad support for a legislative Panel, with the majority of consultation respondents (59%) favouring option B, and 39% supporting option A. Feedback indicated that statutory powers were considered desirable, and in some cases necessary, to secure the participation of relevant services, and to ensure they could be held accountable. There was also a view from many that the issues in this area were a result of system wide problems, which would require a more strategic response.

It is recognised that developing the Panel is complex and further work is underway to define its potential functions and referral criteria, as well as to determine whether legislation would be required to establish it. It’s development remains a priority for delivering systemic and long-lasting change.

Recommendation 4 – A National Peer Support Network should be established to facilitate professionals coming together to learn and share best practice

The Peer Support Network, established in 2024, has brought together learning disability professionals from across Scotland, to share best practice, and to get support with planning services for individuals with particularly complex care needs. The Network is guided by an expert reference group, which includes the voice of lived experience as well as those with expertise in working with, and providing services for, people with complex support needs. The Network meets approximately every eight weeks and its membership includes health and social care interests from across Scotland, including strong representation from HSCPs at meetings. Attendees report that they find the Network helpful and informative, and it is clear that it supports wider interaction, enabling the sharing of information and joint problem-solving.

Topics of focus so far have included:

• Dynamic Support Register
• Housing for Complex Support Needs
• Complex Commissioning of services
• Human rights and collaborating with families
• Transition planning for young people

Complex Support Needs Pathway

Although not one of the four key recommendations, the Coming Home Implementation Report also recommended the development of a Complex Support Needs Pathway to transform how services respond to people with learning disabilities and complex support needs. This was envisaged as a person-centred pathway with timescales and milestones to be used to support discharge from hospital. Initial work was undertaken to develop a Pathway and proposals to complete this work are included later in this plan.