Fraser of Allander Institute's report published on 28 October 2025 "Tracking Progress on Annual Health Checks for People with Learning Disabilities" highlights a range of issues.

The report examines how Scotland is doing at delivering annual health checks to adults (16+) with learning disabilities, based on the latest data for the 2024/25 reporting period. It looks at how many people have been offered checks, how many have completed them, and the variation across different NHS Boards.

It also discusses how service delivery is organised, how the eligible population is identified and recorded, and how this ties into broader issues of health equity and data quality for people with learning disabilities.

Key findings

Here are some of the main points the report highlights:

In 2024/25, 24% of identified adults with a learning disability were offered an annual health check -- up from 6% in 2023/24.

Of those offered a check in 2024/25, 63% completed the check (down from 80% in the prior year).

Of the completed checks, 45% resulted in onward referrals (up slightly from 41% in the previous year).

Large variation exists between NHS Boards: for example, some boards registered no checks in 2024/25 (e.g., one board had zero checks in that period) while others had high referral-rates (e.g., one board had a 92% onward referral rate) suggesting significant differences in both uptake and need.

The system of identifying 'eligible adults' remains incomplete: it only captures people known to primary care or social care services, so the true eligible population is likely larger.

Why this matters

The context for this matter is quite important:

People with learning disabilities face substantial health inequalities: they are more likely to have undiagnosed or untreated health conditions, and a shorter life expectancy. Annual health checks are designed to act as a proactive mechanism to detect and treat health issues early, rather than waiting for problems to become serious.

GOV.UK

The Scottish Government's policy objective is to offer an annual health check to all eligible adults with learning disabilities. But the current figures show the rollout is far from complete.

Improving uptake and delivery of these checks could help narrow the health-gap, improve service planning (since those getting checks generate valuable data), and ensure more people get the support they need. The report points out that without better data, planning will remain hampered.

The report identifies several obstacles and unresolved issues:

Identification and registration: Because different NHS Boards use different processes and registers, many people with learning disabilities may not be known to the system and thus may not be offered a check.

Variation in delivery model and capacity: Some boards are well underway with nurse-led delivery or hybrid models; others are just starting or not yet delivering checks at all. This leads to uneven access.

Data limitations: The eligible population figure, the number offered, and the number completed are all based on the subset known to services, so the numbers underestimate the total need. Further, more granular demographic data (e.g., by age, severity of disability, geography) is lacking.

Funding and sustainability: The report notes that although the Scottish Government committed £2 million annually to implement the checks, many boards feel the resources are insufficient to meet the ambition of offering checks to all eligible adults. Also, recent funding changes (merging into broader frameworks) may affect consistency.

What the report recommends

To improve progress, the report suggests:

Increase efforts to ensure all eligible adults are identified and offered an annual health check, moving from the current ~24% offering rate toward full coverage.

Improve standardisation of data collection and reporting -- including more frequent updates, more detailed breakdowns, and better alignment across Boards.

Consider how the annual health check programme can be used as a tool to build the evidence base about the population of adults with learning disabilities (size, health needs, unmet demand) in Scotland.

Ensure delivery models are sufficiently resourced and supported so that once offered, the follow-through (completion and referral) is effective.

Monitor the quality of the checks and the downstream health outcomes, not just the number carried out. The report notes a formal review of the check format and documentation is underway via the Scottish Commission for People with Learning Disabilities (SCLD) and research funded by the RCN Foundation will examine implementation and impact in early 2026.

While Scotland has made some progress in rolling out annual health checks for adults with learning disabilities, the journey is far from complete. Only about a quarter of identified eligible people have been offered a check, and large regional variations persist.

For this policy to live up to its ambition of reducing health inequalities, more consistent delivery, better data and full engagement of all eligible individuals are crucial.

Read the full report HRE