NIHR Better Health and Care for All review image

The National Institute for Health Research (NIHR) has launched a new review – ‘Better Health and Care for All’ – which explores health and social care services for people with learning disabilities in the UK.

Featuring 23 recent studies, the review looks at health and social care services for people with learning disabilities and shares important findings for those who commission, deliver, work in and use these services. It draws on qualitative research on user experience to randomised trials of complex new services.

Aimed at people with learning disabilities, their professional carers, those delivering and planning specialist services, and for service commissioners, the review provides insights into how services can best meet the needs of all, including those with learning disabilities.

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Additionally, the study primarily looks at studies of health and social care services targeted at people with lived experience of learning disabilities and their families. Although there are a small number of studies on services for children, most are on services for adults.

According to the NIHR, work is needed to improve care for people with learning disabilities, who experience poorer health and die earlier than the general population. Many of these deaths could be prevented by public health interventions or better access to high quality care.

Dr Jean O’Hara, Consultant Psychiatrist at South London & Maudsley NHS Foundation Trust, commented: “The last thirty years has seen big changes in health and social care to support people with learning disabilities. This includes a move from long-stay hospitals to supporting more people to live well in the community. But it is not easy – and we still have a long way to go if this is to be a reality for everyone with learning disabilities across the country.

“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.

“This means not just the development of specialist services, but also reasonable adjustments embedded across the wider NHS to facilitate access to care, digital flagging to ensure people with learning disabilities are more visible particularly when evaluating and planning for services.

“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. It also shows us areas where more research is needed to shape services of the future.”

Within the review, the NIHR makes a series of recommendations about how services can be improved to support people with learning disabilities, which are as follows:

Annual health checks

According to NIHR research, people with learning disabilities are five times more likely than other people of the same age to be admitted to hospital as emergencies for conditions such as urinary infections.

However, the Institute says that this could be avoided by better primary care and that annual health checks by GPs can improve the health and care of people with learning disabilities. Now, the NIHR says that increasing uptake of annual health checks should be a priority in policy and for services.

Dr O’Hara added: “The research in this review confirms that annual checks by a GP can make a real difference in identifying health problems and getting the right treatment. This leads to better outcomes and fewer emergency hospital admissions.”

More research into effectiveness of community learning disability services

The Institute notes that people with a learning disability experience poorer physical and mental health than the general population. It suggests that this could be down to general services not making adjustments to improve access to services.

NIHR has developed and tested a number of treatments and services which have been specially tailored for people with learning disability, including early studies to adapt weight loss interventions. Although the Institute says that more evidence is needed to measure the effectiveness of these services, the studies show that adapting programmes for people with learning disabilities may work best when their care staff or family are involved.

Staff training

Although the outcomes have not been measured yet, the NIHR also recommends training hospital staff in caring for people with learning disabilities during their hospital stay. According to review, several studies showed a lack of confidence amongst hospital staff in caring for people with learning disabilities and further training could improve patient care and discharge times.

Person-centred approach

In the review, the NIHR also says that a person-centred approach – known as positive behavioural support – is recognised as best practice for people with learning disabilities. According to the Institute, one-fifth of adults with a learning disability have behaviour that is challenging and a person-centred approach could help reduce challenging behaviour.

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