In 2020, as part of a long process to form an integrated footballing pyramid structure, all 63 West Region Junior clubs decided to depart and join the newly-founded West of Scotland Football League, a feeder to the Lowland League. Since 2017 more than half of the East Region clubs have departed the Junior ranks, joining the senior East of Scotland Football League which is also below the Lowland League, the remaining clubs in the East Premiership South are expected to join the East of Scotland Football League for season 2021-22. Discussions are ongoing for clubs in the East Premiership North to form a "Midland League" at Tier 6, and also for the North Region to also join the pyramid structure at the same level.