Disabled people face difficulties in accessing primary careBMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7568.565 (Published 14 September 2006) Cite this as: BMJ 2006;333:565
All rapid responses
The BMJ has been at the forefront of efforts to improve the
healthcare of people with learning disabilities.  Sadly, the
aspirations of the Valuing People strategy have rarely been met for this 2
- 3% of the UK population, as confirmed now by the Disability Rights
Commission.  The news article in the BMJ  was discussed today (15
September 2006) during the Department of Health launch of Teaching Public
Health Networks, as a national example of health inequalities that must be
addressed through multi-level, multi-disciplinary action.
One action with at least a little evidence of effectiveness is
'health facilitation' by a community nurse to improve access to and
engagement by primary health care teams.  This promising
linking/brokering innovation for people with learning disabilities can
suit both general practice and service users  but it requires highly
motivated and experienced community nurses to win the trust and co-
operation of all the stakeholders. However, community nursing numbers are
dwindling through both short-sighted cost-cutting and the demoralisation
of the remaining, over-stretched practitioners.
This year, the service commissioning functions in NHS primary care
are undergoing major changes. Clinicians will play an increasing role in
commissioning for their local practices. The crux of the matter is:
will clinicians interested in their patients with learning disabilities
advocate for appropriate service development  within their local area?
 Cooper SA, Melville C, Morrison J. People with intellectual
disabilities. Their health needs differ and need to be recognised and met.
BMJ 2004; 329: 414-415.
 Cole A. Disabled people face difficulties in accessing primary
care. BMJ 2006; 333: 565.
 Harrison S, Berry L. Valuing people: health visiting and people
with learning disabilities. Community Practitioner 2006; 79: 56-59.
 Caan W, Lutchmiah J, Toocaram J, Thomson K. The Final Report on
the Health Facilitators in Barking and Dagenham. Chelmsford: Anglia Ruskin
 Caan W, Hampton-Matthews S. One from the heart for people with a
learning disability. British Journal of Nursing 1999;8:97-100.
Competing interests: No competing interests