Annual general practitioner (GP) health checks are available to patients on the GP register who are aged 14 years and over who have a learning disability. Health checks and resulting action plans help to reduce recognised health inequalities. The number of people who had an annual health check increased by 10% in 2017/18 compared with 2016/17, to 147,180. The NHS Long Term Plan commits to improve uptake of the existing annual health checks so that at least 75% of those eligible have a health check each year.
NHS Improvement has introduced Learning Disability Improvement Standards for NHS trusts in England to help ensure that trusts monitor and review the care they provide to people with a learning disability or autism. Inclusion of the improvement standards in the NHS Standard Contract 2019/20, mandated by NHS England for use by commissioners of all healthcare services except primary care, means that all providers must have regard to the improvement standards.
NHS England and NHS Digital, in partnership with patient and carer groups and other key stakeholders, are working to develop a national ‘reasonable adjustment’ flag to indicate on electronic patient records, the reasonable adjustments which services can make to help people with learning disability access healthcare.
We will shortly consult on introducing mandatory learning disability training, which would support staff to make reasonable adjustments for people with a learning disability.
Since the investigation into the abuse at Winterbourne View and other hospitals, there has been a cross-Government commitment to transform care and support for people with a learning disability or autism who display behaviour that challenges, recognising that people with learning disability achieve better health outcomes living in community settings, receiving social care support and community health services, than as inpatients.
‘Building the Right Support’ set out a plan to build community capacity to allow people to leave hospital (and prevent crisis and therefore admission) to ensure that people with a learning disability or autism are supported to live in the community.
There were 2,325 inpatients with learning disability or autism at the end of December 2018, a reduction of nearly 20% from the baseline number of inpatients in March 2015. Since 2015, there have been over 5,700 discharges into the community, including over 620 people who had previously been in hospital five years or more, and 413 inpatient beds decommissioned.
The NHS Long Term Plan commits to implementing the ‘Building the Right Support’ plan in full, achieving a 35% reduction in inpatients as quickly as possible and no later than the end of 2019/20, and at least a 50% reduction in inpatients (compared to the figure in 2015) by the end of 2023/4 and ensuring that every local economy has specialist community provision.