13 October 2026
by Rab Armour
Yet millions of pounds are earmarked for community support
Around half of Scotland's specialist learning disability hospital beds are not functioning primarily as assessment and treatment services, according to newly published Scottish Government minutes.
The findings raise serious questions about why people who no longer require hospital treatment remain in institutional care, while charities and social care providers face mounting financial pressures.
Newly published minutes of the inaugural Coming Home Delivery Group meeting, held on 16 September, reveal that Scotland has approximately 112 specialist assessment and treatment beds for people with learning disabilities, spread across nine NHS health boards.
However, the group was told that "around half of beds were reported as not functioning primarily as assessment and treatment services".
The findings reinforce concerns that people are being kept in hospitals because suitable housing and community care packages are unavailable.
The Scottish Government's own Coming Home Action Plan, published in March, acknowledged that between 40% and 50% of people with learning disabilities and complex needs in hospital had been classified as delayed discharges.
It also admitted that some people were being admitted to hospital following the breakdown of community support arrangements rather than because they required clinical treatment.
Officials warned this could prevent others with genuine medical needs from accessing specialist beds, increasing the risk of patients being sent to facilities far from their families.
The plan also identified inconsistencies between health boards, with some operating more beds than appeared necessary and others relying on bespoke arrangements that had effectively become long-stay institutions.
The September meeting discussed a proposed national vision for inpatient care built around the principle that "hospital is not a home".
It called for admissions only where there is a clear clinical need, alongside the development of community alternatives and an end to unnecessary long-term institutional care.
But the minutes also reveal questions about the pace at which funding is reaching those needing support.
The £20 million Coming Home Fund was announced in March to help almost 400 people with learning disabilities and complex support needs live in their own communities.
Yet by the September meeting, just 18 completed applications had been received from 13 local authorities.
These concerned seven people in hospital, six in inappropriate placements outside their local areas and five whose existing support arrangements were at risk of breaking down.
Only the first award was reported as having been approved, enabling one individual to move into accommodation.
Applications had opened on 3 August, meaning the figures cover approximately six weeks rather than the fund's longer-term performance.
Members identified several potential barriers to accessing the money, including difficulties funding adaptations before formal awards were agreed, financial guardianship arrangements and uncertainty over whether shared accommodation would qualify.
There were particular concerns that applications could be rejected when people did not hold individual tenancies.
The group was told that an earlier requirement for recipients to be able to move within three months had been removed.
The funding is intended to complement existing statutory support rather than replace council or health and social care partnership responsibilities.
The disclosures come against a background of repeated warnings about the human cost of institutional care.
In January 2025, the Scottish Human Rights Commission concluded that people with learning disabilities and autistic people were continuing to be held in institutions in breach of their human rights.
Its investigation also found that more than £12.5m of a previous £20m Community Living Change Fund remained unspent entering its final year.
Some of that funding had been used to refurbish institutional settings rather than support independent living, the commission reported.
Professor Angela O'Hagan, chair of the commission, said at the time: "It is troubling to find such little progress has been made and that clear failures to uphold human rights continue."
The Scottish Commission for People with Learning Disabilities (SCLD) also raised concerns when the latest Coming Home Action Plan was published.
Lorne Berkley, the organisation's policy and rights lead, warned: "We know that institutional living can result in harm and trauma for people with learning disabilities and leaves them vulnerable to abuse."
SCLD welcomed the additional investment but called for greater accountability for people stuck in hospital and changes to ensure their right to independent living.
Questions also remain over whether the organisations expected to provide alternatives to hospital care are receiving adequate funding.
In August, the Coalition of Care and Support Providers Scotland (CCPS), which represents third sector social care organisations, published research warning that fragmented funding and commissioning arrangements were undermining providers' ability to deliver sustainable services.
Its report found that charities were spending substantial organisational resources navigating complex funding arrangements while struggling to influence decisions about how services should be redesigned.
CCPS chief executive Rachel Cackett said: "Things aren’t working, and CCPS and its members already hold many of the answers to how this system can work differently."
The Scottish Government's own action plan acknowledges that complex community support packages must be adequately funded to provide specialist staff training, management oversight and long-term stability.
It also recognises the disparity in pay and conditions between NHS employees and social care workers employed by charities and independent providers.
The plan proposes transferring resources from hospitals into community services, alongside closer collaboration between health boards, councils and care providers.
However, that transfer of resources is identified as a long-term action, raising questions about how quickly suitable community alternatives can be established.
Meanwhile, the September minutes reveal further concerns about people potentially falling outside existing monitoring arrangements.
Members questioned the exclusion of autistic people without learning disabilities, people in forensic settings and children and young people moving between services.
These groups are not all covered by the existing Dynamic Support Register, which is designed to identify people at risk of unnecessary hospital stays, unsuitable placements or breakdowns in care.
Officials agreed that the exclusions should be examined through future work, with revised guidance expected in early 2027.
There have been signs of improvement.
When the latest action plan was announced in March, Scottish Government figures identified 391 people in the urgent category of the Dynamic Support Register.
Of these, 68 were classified as delayed discharges, down from 84 in December 2024, while 28 were in inappropriate out-of-area placements, compared with 53 previously.
Another 187 were at risk of their support arrangements breaking down.
Separate work identified 32 people who had spent more than ten years in hospital as of October 2025.
Announcing the new funding in March, social care minister Tom Arthur said: "Every day spent unnecessarily in hospital is time away from someone's community, family and friends."
He insisted progress was being made but acknowledged that further work was needed.
The Coming Home programme is jointly led by the Scottish Government and Cosla, with charities and independent care providers among the organisations expected to help deliver its objectives.
A new Strategic Oversight Group is scheduled to meet for the first time on 22 October.
The Delivery Group is next scheduled to meet on 14 January.
Learning disabled hospital beds not being used for purpose - TFN
The above information is from a Third Force News (TFN) Weekly Health & Social Care roundup Newsletter Wed 14/10/2026