Six out of ten GP surgeries are signed up to the Directed Enhanced Scheme in England, but 40% of patients with learning disabilities did not get a health check

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The Directed Enhanced Scheme offers reimbursement to GP surgeries to carry out annual health checks for people with learning disabilities. Here, we report on a cohort study which looked at the impact of the scheme over a three year period.

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Health Professionals’ views on care pathways for adults with learning disabilities

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The health inequalities of people with learning disabilities are well documented in the literature, with increased risks for many physical and sensory health issues as well as mental health issues and responses from health services have often been poor, as documented in the Michael Report. In recent years, the healthcare pathways approach has been introduced [read the full story…]

Vulnerabilities of people with learning disabilities continue to compromise their safety in NHS hospitals

Good quality healthcare

Background A number of reports in recent years have highlighted concerns about the treatment of patients with learning disabilities in NHS hospitals, highlighting poor communication, incorrect assumptions about quality of life and poor understanding by healthcare professionals putting people at continued risk of poor care – and even death. In 2008, the publication of the [read the full story…]

Atlas maps health of adults with learning disabilities in Ontario, Canada

health care atlas

Background We have posted extensively about the current state of knowledge around the health care needs of people with learning disabilities and the nature of the responses by UK health providers. The Mencap Getting it Right campaign launched after the publication of Death by Indifference’, aims to support local campaigners, health professionals, GP surgeries, hospitals [read the full story…]

PCTs underperforming in provision of annual health checks for people with learning disabilities continue to do so

RCGP annual health check guidance

Annual health checks for people with learning disabilities were introduced as part of the Direct Enhanced Service in England in 2008 and a recent review of studies involving over 5000 people with learning disabilities showed that the provision of checks consistently found unmet health needs and enabled targeted action to address these needs. Health checks [read the full story…]

BMA launches Mental Capacity Act toolkit for doctors, to raise awareness and support decision making

MCA toolkit

The Mental Capacity Act 2005 came into force in England and Wales in 2007 to provide a legal framework for decision-making on behalf of people who cannot make decisions themselves. We have posted previously about the lack of practical knowledge of the working of the Act amongst learning disability community teams  and pointed to articles [read the full story…]

Healthcare for people with learning disabilities DH progress report and consultation

six lives progress

The Six Lives report in 2009 investigated the provision of public services to people with learning disabilities following the deaths of the six people with learning disabilities highlighted in Mencap’s Death by Indifference report. The Department of Health in its response committed to providing progress reports on the recommendations and this report has been recently [read the full story…]

Needle phobia overcome in one case study by use of changing criterion and differential reinforcement


Fear and anxiety about medical procedures can be a barrier to accessing healthcare for people with learning disabilities. In particular, fear of needles can mean that blood tests may not be able to be taken and this can prove a significant clinical challenge. The researchers in this case study used a changing criterion design, they [read the full story…]

Learning Disability Nursing workforce examples urgently needed for Compassion in Practice consultation

compassion in practice

Following concerns raised by recent investigations into the quality of healthcare of the national nursing strategy, ‘Compassion in Practice’ has set out a vision for nursing based on the 6 ‘C’s of Care, Compassion, Competence, Communication, Courage and Commitment. Action area 5 of the strategy is looking at ensuring right staff with the right skills [read the full story…]

Taught course for medical students not enough to change attitudes towards people with learning disabilities


A couple of years ago, I was involved in some work commissioned by the General Medical Council to create a website for doctors to help them to understand their duties under GMC guidance. Amongst the many striking things about this work was some video on the site taken of some doctors in training, attending a session [read the full story…]