Bradford VTS Online Resources:

Clinical Knowledge

Intellectual Disability

Intro

According to Public Health England, about 2.5% of the population has a learning disability (LD). Yet most GP LD registers show only about 0.4% of their practice population. The ‘missing’ 2% might be people with a mild learning disability, or with other diagnoses which appear on the disease register but are not separately recorded. This includes, for example, people with Down’s Syndrome, autism or cerebral palsy that also have a learning disability.

Why is this area important?

Because people with a learning disability face many distinct health inequalities:

  • Significantly reduced life expectancy, 18 years lower for women and 14 years lower for men (NHS Digital 2017-18).
  • Poorer nutrition and increased likelihood to be either obese or underweight. They are less likely to have help for their obesity, including screening for thyroid disease and diabetes.
  • Very low attendance in the three national cancer screening programmes (breast, bowel and cervical).
  • Very low uptake of flu immunisation yet respiratory infection is one of the most frequent causes of preventable deaths.
  • The Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD) found, over a quarter of deaths could be prevented with better-quality healthcare. Recently, the learning disabilities mortality review (LeDeR) raised this figure to over a third.
  • Greater prevalence of epilepsy and severe mental health illnesses. Also, multimorbidity, complexity, polypharmacy and greater likelihood of adverse events from incompatible interventions (PHE 2017).

Important features in the history

  • If you would like to have a go at adding some “top tips” to this page for this specialty (and have your name displayed proudly with bradfordvts),  please email me – [email protected]

Important features in the Examination

Red Flags

Other Top Tips - practice tips.

Anyone with LD > Age 14 should:

  1. Be offered a specific LD related Annual Health Check
  2. Have a health action plan to address health issues identified in the check. You could include the social prescribing contact in your practice to support people to be able to address these actions.

Practices must:

  • Maintain a ‘health check register’ of patients aged 14 & over with LD
  • Check the number on their LD register reflects the current prevalence (at least 0.5%).
  • Have a nominated lead who coordinates staff training, delivering the ES, provides the AHCs
  • Attend a MDT education session. 

THiNK LD campaign

How do I THiNK LD?

Use my mnemonic LEAF.   L is for Learning Disability.   E is for Equality.  A is for Access.  F is for Flexible.    So, in Learning Disabilities, think E, A, F. 

  1. THiNK ACCESS
    Is there anything stopping people with learning disabilities using the service our surgery provide?
  2. THiNK FLEXIBLE
    Can our surgery offer any adjustments that could improve people’s experience?
  3. THiNK EQUALITY
    Will people with learning disabilities have the same outcomes as anyone else?

Please leave a comment if you have a tip, spot an error, spot something missing or have a suggestion for a web resource.
And of course, if you have developed a resource of your own, please email it to me to share with others.

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