What is a learning disability?
According to Valuing people: A new strategy for learning disability for the 21st century, the government White Paper for England about health and social care support for people with a learning disability (2001), an individual who has a learning disability has the presence of:
- a significantly reduced ability to understand new or complex information or to learn new skills
- a reduced ability to cope independently
- an impairment that started before adulthood, with a lasting effect on development.
This means that the person will find it harder to understand, learn and remember new things, and means that the person may have problems with a range of things such as communication, being aware of risks or managing everyday tasks.
What is a learning difficulty?
A learning difficulty is not a learning disability. This includes:
- Special Educational Needs (SEN)
- difficulties arising from brain injury occurred later in life
Tips for successful remote consultations with patients with additional needs
To make consultations with patients who have additional needs, such as learning disabilities, as successful as possible, it can be helpful to:
- allow more time for them
- check regularly that the patient is finding the consultation helpful
- consider whether other forms of communication would be more suitable
- augment the consultation with written material and follow up via email
- have family members or carers present
- apply a lower threshold for a comfort follow-up call the next day than you would normally.
See the Downloads section for easy-read advice on coping with Covid-19, staying safe and staying at home, for both those with learning disabilities and their carers. MenCap has also produced easy-read advice explaining Covid-19.
Beyond Words, a charity that provides books and training to support people who find pictures easier to understand than words, also has a selection of useful Covid-19 related resources on its Coping with Coronavirus page.
Easy-read patient information leaflets on a variety of conditions and medications can be accessed via the EasyHealth website and the Bild website. The Royal College of Psychiatrists also has resources and leaflets available for people with learning disabilities in easy-read format and for their carers and clinicians. This includes information about capacity and consent.
NHS England has produced a series of leaflets to help families and carers of people with a learning disability know the signs of constipation, which can have fatal consequences more often in this group than in the population as a whole, and what to do if you think someone is constipated.
MenCap has produced a hospital communication book to help ensure people with learning disabilities get equal treatment and service when visiting the hospital.
See also the Mental Capacity Act (2005) and the RCGP Mental Capacity Act Toolkit.
Initiatives to stop over-medication
STOMP and STAMP are initiatives to stop over-medication and support appropriate treatment in children with learning disabilities. This NHS leaflet provides information on STOMP and STAMP to help families become more involved in discussions regarding psychotropic medication.
How to prepare your patient for a hospital visit
- ask the patient's carer to fill in a Hospital Passport for them to take into hospital (this contains basic information to help them and the hospital staff if admission to hospital is needed or when attending an appointment)
- encourage the patient to watch the UCLH or RFH video prior to their visit
- notify the hospital acute liaison nurses for learning disability patients that the person is coming in:
- print off/encourage the patient to read the relevant easy-read leaflets on the UCLH website.
Reporting the death of a person with a learning disability
The Learning from Lives and Deaths of People with a Learning Disability and Autistic People Programme (LeDeR) is a national review of deaths of people with learning disabilities.
Please use the LeDeR website to report a death of patient with learning disability who was aged more than four years old.
The LeDeR annual report from 2020 is available on the NHS website.
Learning disability annual health checks
See Downloads and the links below for useful resources to help you carry out annual health checks for people with learning disabilities.
The pre-health check questionnaire is designed to be sent out to service users, providers and carers prior to the health check taking place. It is used to gather information to help inform the health check itself, and should therefore be sent back to the practice in good time.
Area specific guidance for Camden
Here is a selection of useful information for GPs and carers of those with learning disabilities:
Area specific guidance for Barnet
Say No to Abuse
My Health Matters
In Barnet, a new Health Action Plan called My Health Matters has been developed. My Health Matters folders are given out to everyone with a learning disability in Barnet. Service users, carers and families can contact the service via the duty desk to arrange training by phoning t: 020 8359 6161.