Better Health and Care for All

February 7, 2020

A new review, Better Health and Care for All, has highlighted evidence on the realities of health and social care services for people with learning disabilities.

Published by the National Institute for Health Research (NIHR), the review looks at research evidence, and brings together 23 published studies funded by the NIHR examining aspects of health and social care services for the more than one million people in the UK with a learning disability.

People with learning disabilities have poorer health and die earlier than the general population and work is needed to improve how health and social care services are organised and delivered to people with learning disabilities, says NIHR.

The review considers the evidence produced by studies in four key areas of health and care:

  • Identifying health risks.
  • Keeping well in the community.
  • Staying well and safe in hospital.
  • Supporting positive behaviour.

It also identifies studies that have been especially good at involving people with learning disabilities in the research.

Better Health and Care for All has found that:

  • Little more than half of people with learning disabilities are having annual health checks with their GP, even though research shows that these checks can improve their health and care, and address health problems that may result in hospital admissions and poor health in the long term.
  • People with learning disabilities have poorer health than the general population and are more likely to be admitted to hospitals as emergency cases – research shows this is five times greater for conditions like urinary infections which could be prevented by better community and primary health care.
  • Swallowing problems are common among people with learning disabilities and put them at risk of respiratory infections, including pneumonia, and can create an increased risk of emergency hospitalisation. Health checks and GPs assessing the need for meal-time support could reduce these risks.
  • Depression and anxiety are more common in people with learning disabilities than the general population. Two studies show that it is possible to adapt interventions for low-mood and anxiety, including input from the person’s usual carers.
  • General hospitals vary greatly in how well they identify and make adjustments for patients with learning disabilities. Many hospitals lack systems to effectively flag-up patients with learning disabilities, and family carers are often not involved in care processes. Learning disability nurses were found to make valued contributions to care.
  • Some people with learning disabilities exhibit behaviour that challenges. Initial small studies found that person-centred approaches made a difference, but larger trials showed little effect. One study reduced challenging behaviour by two thirds when staff were supported to find better ways of engaging and working with residents. This is important as other research showed only one third of people in community group homes got good support to stay active and social.

Dr Jean O’Hara, former National Clinical Director for Learning Disabilities at NHS England, said, 'We know that people with learning disabilities still experience poorer health outcomes and are more disadvantaged than others. This is why we have made reducing health inequalities and improving quality of care for people with learning disabilities one of the top priorities in the NHS Long Term Plan….[research] evidence can give us insights into the services and support needed for every individual to have the best chance of living a full and happy life.'

Better Health and Care for All is available to download from the NIHR website.

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