Insights into learning disabilities and complex needs: statistics for Scotland

About this release

This quarterly release by Public Health Scotland (PHS) presents statistics relating to adults with learning disabilities who have complex care needs and are registered on a Dynamic Support register (DSR). The purpose of a DSR is ultimately to avoid people with learning disabilities living or staying too long in hospitals, or in out-of-area placements which they/their family have not chosen. It is designed to help professionals working with people with learning disabilities to better respond to situations where there is a need for a more intensive level of care management.

These statistics contain the first release of data for the DSR census at 25 December 2025.

Main points

In Scotland, as at 25 December 2025:

• An estimated 1,500 people were registered on the DSR. This is a 2% decrease from the estimated number of people on the register this time last year (1,530 on 26 December 2024).
• Of those people on the DSR, 391 were classified in the urgent category and fall into one of the three sub-categories below. The urgent category requires intensive review of support plans and packages with and for the people identified:
  • there were 176 people in hospital, of which 68 were classified as a delayed discharge. This is when a person is clinically ready for discharge from inpatient hospital care but continues to occupy a hospital bed beyond the date that they are ready for discharge.
  • there were 28 people recorded as an inappropriate out-of-area placement. This is a placement which the person and/or family did not choose, and which nevertheless occurred because of a lack of suitable resources and/or accommodation within the person's preferred community setting.
  • there were 187 people recorded as at risk of support breakdown. This is when a person's current living situation has become unsuitable. For example, the family carer is unable to continue caring, there are concerns about the suitability or stability of a placement or there is an increase in severity and frequency of challenging behaviour.
• Just over 99% (1,488) of people on the DSR had their sex recorded. Of the 1,488 people, just over 62% are male and just under 38% are female. This pattern of males being higher than females is consistent with the Scottish Government's Coming Home report for DSR categories where a sex breakdown was available.

Background

The use of a DSR was a key recommendation of the Coming Home Implementation report. It is applicable to adults (aged 18 plus) with learning disabilities with complex care needs whose support is funded by a Local Authority or NHS Board. Along with improving visibility of people with learning disabilities and complex care needs, the DSR is also a tool to support local planning and decision making. It is to be utilised and maintained by each Health and Social Care Partnership to overcome challenges in supporting individual needs, care requirements and risk assessments when collaborating across both health and social care.

People can only be included on a local DSR following discussions across the Health and Social Care Partnership Learning Disability Team at a multidisciplinary team meeting. Using risk screening criteria, the team will agree if the person should be added to the Register and at what level of priority. There are two levels within the Register; red, which is high risk, and amber, which is moderate risk, but still requires monitoring. 

A person can be removed from the DSR if:

• they are more than 6 months discharged from hospital or other placement and are judged to be settled and no longer at risk.
• the service where the person is living has improved considerably and would no longer be considered a poor, inappropriate or institutionalised service.

Further details on inclusion, priority levels and conditions for removal are available in Appendix One of Coming Home Implementation report.

The statistics presented in this publication are derived from snapshots of the local dynamic support registers which are submitted quarterly to PHS by Health and Social Care Partnerships.

Further information

The next release of this publication will be June 2026.