Letters Meeting needs in learning disability

All opportunities should now be taken to meet the needs of patients with learning difficulties

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4190 (Published 02 July 2013) Cite this as: BMJ 2013;347:f4190
  1. Matthew A Hoghton, general practitioner and lead investigator1,
  2. Pauline Heslop, senior research fellow and team manager1,
  3. Anna Marriott, research fellow and project worker1,
  4. Peter Fleming, professor of infant health and developmental physiology and chair of overview panels1,
  5. Lesley Russ, public health specialist (learning difficulties and autism) and lead nurse1,
  6. Peter Blair, senior research fellow and statistician1
  1. 1Confidential Inquiry into Premature Deaths of People with Learning Disabilities, Norah Fry Research Centre, University of Bristol, Bristol BS8 1TZ, UK
  1. Matt.Hoghton{at}bristol.ac.uk

Hollins and Tuffrey-Wijne recently highlighted some of the key findings of the Confidential Inquiry into Premature Deaths of People with Learning Disabilities.1 We await the minister of state for care and support, Norman Lamb, and the Department of Health’s response before the end of June 2013. However, the 18 key recommendations will need sustained action from all of us involved in health and social care, and there are opportunities to make a difference now.2

In England the directly enhanced service for learning disabilities offers a comprehensive annual health check to adults with learning disabilities, and that for dementia offers a dementia assessment to all people with learning disabilities aged 50 years or more, or those with Down’s syndrome aged 40 years or more. These directly enhanced services need a long term commitment—from GPs to offer them and from NHS England to commission them.

In 2004 the National Patient Safety Agency recognised the vulnerability of people with learning disabilities in general hospitals, and subsequent studies identified the importance of hospital based learning disability liaison nurses.3 4 These posts should be introduced to all hospitals in England as a matter of priority.

The NHS Outcomes Framework 2013-14, domain 1.6, has set an indicator for reducing excess deaths in adults with learning disabilities under 60 years. A review of “all cause of death” certificates registered in England between 2004 and 2008 found that respiratory diseases were associated with the deaths of 52% of people with learning disabilities compared with 25.6% of people without a learning disability.5 Unfortunately the flu immunisation programme 2013-14 has not identified adults with learning disabilities as a risk group to receive the flu vaccine, other than those in long stay residential homes.6 This is a missed opportunity.


Cite this as: BMJ 2013;347:f4190



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