Special focus, knowledge, and skill required to ensure healthcare needs of people with learning disabilities are met


We have posted a number of times about the healthcare needs of people with learning disabilities and in particular the responses of the healthcare services. Recently, the results of the Confidential Inquiry into Premature Deaths of People with Learning Disabilities was published which found that men with learning disabilities died on average 13 years earlier than men in the general population, with this figure rising to 20 years for women.

The BMJ this week carries an editorial which supports a number of recommendations for action. Hollins and Tuffrey Wijne point out that a recent study about to be published suggests a lack of reasonable adjustments in health services contributes to poor care received by people with learning disabilities in healthcare services.

They also point out that the establishment of the confidential enquiry took 10 years to establish, whereas enquiries into child death, maternal deaths and perinatal mortality were established much more quickly.

They point out that there is good evidence from the United States that the system of intellectual disability mortality reviews has ensured that questions raised about individual circumstances and systemic concerns have led to changes in practice.

This would suggest that the call for an ongoing national learning disability mortality review should be supported.

They also suggest that NHS England require new clinical commissioning boards

  • ensure that people with learning disabilities are clearly identified in the healthcare system, ensure that specialist advocacy is available
  • ensure families are included as expert care partners,
  • ensure reasonable adjustments are made to take account of particular vulnerabilities.

They conclude that “Patients with learning disabilities—perhaps more than any other patient group—need special focus, knowledge, and skill to ensure that their healthcare needs are met. All of this requires clinical leadership and a strong commitment at policy level.”

Meeting the needs of patients with learning disabilities, A recent inquiry highlights failings in the delivery of care to this vulnerable group, Hollins S & Tuffrey-Wijne I, British Medical  Journal, 2013;346:f3421 29.5.13

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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