Improving primary health care for people with learning disabilities

Abstract

'Signposts for Success' (Department of Health (DoH), 1998a) states that specialist learning disability services (SpLDS) must promote liaisons with, and offer specialist advice to, primary healthcare teams (PHCTs). With the advent primary care groups (DoH, 1998b), genuine collaboration and partnership-forging is necessary and timely to prevent people with learning disabilities being excluded from healthcare services. The project described in the article had three broad aims: first, to establish a practice register of people with learning disabilities in all practices involved in the project; second, to enable practice nurses (PNs), with support, to carry out a systematic health check within the practice of people with learning disabilities; and third, to enable the project nurse to act as a crucial link between SpLDS and the PHCT. The health checks highlighted unmet health and social needs, which were then met through appropriate referral and intervention, mainly to specialist services. Follow ups were conducted to measure any health gain as a result of the applied Interventions. Evidence of health gain was revealed, pointing to the clinical effectiveness of performing such checks within the PHCTs.

The impact of health checks for people with intellectual disabilities: An updated systematic review of evidence

“…This supports the finding of the previous review that studies consistently provide evidence of health checks leading to targeted actions to address identified health needs (Baxter et al, 2006;Bollard, 1999;Hunt et al, 2001Hunt et al, , 2006Lennox et al, 2006Lennox et al, , 2007Lennox et al, , 2008Lennox et al, , 2010Lennox et al, , 2011Martin, Axon, et al, 2004;Martin, Philip, et al, 2004;McConkey et al, 2002;Webb & Rogers, 1999). In the UK, an audit of actions resulting from health checks for 190 participants, of whom 93 had new health needs identified, indicated that management had been initiated for 90% of identified needs by the time of the audit and treatment concluded for 61% of needs (Baxter et al, 2006).…”

“…A further newly identified study in Northern Ireland analysed information gathered from GP returns regarding health checks to the Health and Social Care Board, as well as a sample of patient satisfaction questionnaires from GP practices and feedback from primary care staff obtained at a consultation workshop (McConkey, 2013). A number of other studies, three of which were newly identified, used questionnaires, interviews, or workshop discussions to look at the views of service users, carers, GPs or practice nurses with regard to health checks (Barr et al, 1999;Bollard, 1999;Cassidy et al, 2002;Chapman, 2012;Lennox et al, 2013;Martin, Roy, Wells, & Lewis, 1997;McConkey et al, 2002;Walmsley, 2011) and one was based on a cross-sectional survey of community learning disability nursing services in Scotland (McKenzie & Powell, 2004). Of other newly identified articles: one study used focus groups to look at the views of service users regarding health checks and this was pooled with additional focus group data looking at service user experiences of primary healthcare (Perry et al, 2014); clinical audit was used to evaluate health checks in relation to the recording of information for specific questions (Codling, 2007(Codling, , 2012; and inclusive research involving people with intellectual disabilities visiting GP surgeries has been reported (Michell, 2012).…”

“…Overall, the majority of the publications identified were based on studies conducted in the UK, including 19 from England (Backer & Jervis, 2007;Bollard, 1999;Cassidy et al, 2002;Chapman, 2012;Chauhan, Kontopantelis, Campbell, Jarrett, & Lester, 2010;Chauhan et al, 2012;Codling, 2007Codling, , 2012Hunt, Wakefield, & Hunt, 2001;Hunt, Rankine, & Blackmore, 2006;Martin, Axon, & Baillie, 2004;Martin, Philip, et al, 2004;Martin, 2003;Martin, Roy, Wells, & Lewis, 1997;Michell, 2012;Walmsley, 2011;Wells, Turner, Martin, & Roy, 1997;Wilson & Haire, 1990), 5 from Wales (Baxter et al, 2006;Felce et al, 2008aFelce et al, , 2008bJones & Kerr, 1997;Perry et al, 2010) 4 from Scotland (Cooper et al, 2006;Jones et al, 2009;McKenzie & Powell, 2004;Romeo et al, 2009), and 3 from Northern Ireland (Barr et al, 1999;McConkey, 2013;McConkey, Moore, & Marshall, 2002). Additional publications were identified based on studies conducted in the following countries: 8 from Australia (Beange et al, 1995;Gordon, Holden, Ware, Taylor, & Lennox, 2012;Lennox, Green, Diggens, & Ugoni, 2001;Lennox, Rey-Conde, & Cooling, 2006;Lennox et al, 2007Lennox et al, , 2010Lennox et al, , 2013Lennox, Rey-Conde, & Fa...…”

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

“…Uncontrolled studies in the UK have reported a variety of benefits of health checks, including improved seizure control and weight management. [33][34][35][36] These UK studies were small, with fewer than 100 participants. One larger before-and-after study of a domiciliary preventative intervention in the USA found a reduction in self-reported pain, falls and emergency room visits, 37 whereas another larger US study suggested that health screening may help to resolve psychiatric problems by identifying physical problems.…”

Prescribing Contraception to Women with Intellectual Disabilities: General Practitioners’ Attitudes and Practices

“…A possible solution to this lack of expertise is to make active links with those who are experienced and skilled in working with people with intellectual disabilities and community nurses are the obvious choice [24]. Whether community intellectual disability nurses fulfil the role of health facilitators for individuals or have more consultative role within the GP practice as a whole, both strategies would seem like an improvement on the current situation.…”