Evidence Hub

Improving access to primary care and annual health checks for people who have a learning disability.

Quick-read summary

Researchers interviewed people with learning disabilities, and those who support them, to find out their views on how easy it was to access primary care and health checks. They also spoke to health care providers.

The research highlights several issues that have an impact on people with learning disabilities attending primary care appointments – and provides some recommendations for primary care.

One key recommendation is that people with learning disabilities should be prioritised for annual health checks, and supported to attend them.

Who is this evidence useful for?

Primary care providers (GPs and practice nurses), policy makers, people with learning disabilities and those who support them.

What is the issue?

Previous research shows that:

People with learning disabilities experience more health vulnerabilities, so prioritising the health needs of people with learning disabilities is important.

Annual health checks can uncover unknown conditions, reduce preventable emergency hospitalisations, allow monitoring, and support continuity of care.

However, people with learning difficulties can sometimes face challenges and barriers when trying to access GP appointments and annual health checks.

Barriers include fear, embarrassment, time, and carer unawareness of health problems. People with learning disabilities may lack assertiveness and communication skills or need a carer to support with an appointment.

This study gathered views on ways to improve GP primary care access for people with learning disabilities, and worked with service users and professionals to co-produce recommendations for change.

What the research found

The research led to the co-production of a set of recommendations for primary care, based around five themes:

• Prioritisation – including offering longer appointments and allowing enough time for thorough health checks for patients with learning disabilities
• Proactivity – including accurately identifying patients with learning difficulties, and reaching out to them
• Innovation and improvement – including better training for health professionals and sharing good practice
• Personalisation – people with learning disabilities valued seeing the same person, and it supports continuity of care
• Prevention and follow-up – after the appointment, supporting patients with information to make healthy choices, or supporting them to make any follow-up appointments

Other recommendations

• Provide spaces for people with different needs
• Use health questionnaires
• Offer extra help for those living unsupported
• Having a proactive, flexible approach to suit the person
• People with a learning disability want us to stop using ‘annual’, and use plain language, ‘yearly’, when they get a health checks.

Why is this important?

The research highlights that improvements are needed in primary care to meet the needs of patients with learning disabilities.

This work provides recommendations for primary care providers to use and build on.

The recommendations will help primary care providers to support patients with learning disabilities more effectively.

The recommendations can be used immediately, alongside existing guidance and as a summary to guide training and service development.

How were patients or members of the public involved in this research?

The researchers spoke with patients with learning disabilities, and their carers, to find out more about their experiences of accessing primary care. As part of this, they worked closely with the Lawnmowers Independent Theatre Company – which is delivered by and for people with learning disabilities.

What’s next?

Future research should explore standardised methods of identifying and coding reasonable adjustments for patients, as well as innovation to improve access to primary care. This could include thinking more carefully about automated phone and check-in systems.

Lead researcher

Simon Hackett, Newcastle University

Get in touch about this research

[email protected]

Access the full paper

Improving access to primary care and annual health checks for people who have a learning disability: a multistakeholder qualitative study- BMJ Open