Annual health checks for people with learning disabilities

Headnote

Julie Chapman shows how the implementation of a directed enhanced service at GP practices in Portsmouth has improved patient care

Abstract

This article describes the implementation of annual health checks for people with learning disabilities by GPs in Portsmouth. It discusses how learning disability service link nurses work in partnership with the practices, supporting the implementation of the health checks, which are offered as a directed enhanced service. Implementation of the checks is an example of good practice that can improve healthcare outcomes for this patient group.

Keywords

Annual health check, directed enhanced service

People with learning disabilities tend to have a greater need for health care than the general population, but are less able to access services and they receive poorer care if they do (Glasby 2002, Mencap 2007, Department of Health (DH) 2008, Gibbs et al 2008, Parliamentary and Health Services Ombudsman 2009, Emerson et al 2011).

Statistics suggest that people with learning disabilities are 58 times more likely to die before the age of 50 than the general population, and that some of these deaths are avoidable (DH 2008, 2009, Royal College of Nursing 2011).

In response to these inequalities, a recommendation was made by the Disability Rights Commission (2006) to offer annual health checks in general practices to people known to have learning disabilities. The health checks were launched in Wales as a directed enhanced service (Robertson et al 2010)

Portsmouth Primary Care Trust (PCT), now known as NHS Portsmouth, set up a programme of annual health checks in 2007, initially as a locally enhanced service (LES), which is an initiative devised to meet the health needs of local people.

In 2009, however, directed enhanced services (DESs) were introduced (British Medical Association and NHS Employers 2009). These are special services or activities that are negotiated and funded nationally, ensuring that they have greater status than LESs, but are provided locally and voluntarily by GPs (British Medical Association and NHS Employers 2009, NHS Employers 2011).

Research suggests that the health checks can lead to improved healthcare outcomes, including reductions in the number of deaths from cancer (Royal College of General Practitioners Learning Disability Group 2010), and to the identification of previously undiagnosed medical conditions (Robertson et al 2010).

The programme of...