The first national publication of data from Dynamic Support Registers for people with learning disabilities and complex care needs has been published by Public Health Scotland. The Dynamic Support Register was launched in May 2023, as one of the key recommendations from the Coming Home Implementation report.

The Coming Home Implementation report set an ambitious mission of reducing delayed discharge and out-of-area placements to the point that out-of-area residential placements are only made through individual or family choices and people are only in hospital for as long as they require assessment and treatment.

The Public Health Scotland publication is intended to increase visibility of local and national data to support the Scottish Government’s work to improve monitoring of people with learning disabilities and complex care needs who are in hospital, in out-of-area placements and whose current support arrangements are at risk of breaking down.

In Scotland, as of the collection date there were 1,243 people on local dynamic support registers. Of those, 455 were classified as urgent within the following categories:

• 171 people in hospital of which 86 are delayed discharge
• 130 people recorded as an inappropriately out-of-area placement and
• 154 people recorded as at risk of support breakdown

The Minister for Social Care, Mental Wellbeing and Sport, Maree Todd said in a letter to the Health, Social Care and Sport Committee:

“This publication provides new, valuable and importantly regular data on this population that has not previously been routinely collected on a national basis. I am confident that this new data will bring much needed visibility, and with it accountability for people with learning disabilities and complex care needs, particularly those who have been delayed from hospital discharge or living inappropriately out-of-area for too long.”

The Minister also accepted that there has not been the reduction in numbers that the Coming Home Implementation report aspired to and admitted that it remains completely unacceptable that people with learning disabilities and complex care needs are spending longer in hospital than is medically necessary and living far away from their homes and families.

In addition to the Dynamic Support Registers two further recommendations from the Coming Home Implementation Report said that the Scottish Government should:

• Establish a National Support Panel that provides professional advice to Health Boards, Integration Authorities and local authorities and provides recommendations on how to resolve complex cases
• Establish a Peer Support Network for professionals from Health and Social Care Partnerships, clinicians, commissioners, social care providers, housing organisations, local authorities, family members, third sector organisations and other relevant stakeholders to provide an informal group for people to share best practice

The Learning Disability, Autism and Neurodivergence Bill may provide an opportunity to enshrine the key recommendations from the Coming Home report in legislation. This will be a priority area for SCLD as we engage in the consultation process over the coming months. It remains critical that people with learning disabilities and complex care needs are supported to live in their own homes and communities, and can be involved in the decision making process around this and that existing barriers to community living within local areas and public bodies are overcome.

Read Ms Todd’s letter to family carers

Ms Todd’s letter

Ms Todd’s letter – Easy Read