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Difficulty accessing healthcare elevated Covid risk for people with learning disabilities, report finds

by Jess Hacker
13 October 2021

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Those with learning disabilities faced barriers to accessing healthcare during the pandemic, which most likely contributed to their elevated risk of Covid-19 mortality, MPs have concluded in a report into the UK’s Covid response.

Based on evidence from over 50 witnesses and 400 written submissions, the Coronavirus: lessons learned to date report addressed ‘serious errors’ in the Government’s initial response to the pandemic.

It highlighted that the Covid death rate among adults with learning disabilities was 3.6 times the rate of the population as a whole.

This, it said, was in part because people with learning disabilities were ‘more likely to struggle’ to access healthcare that would have been available before the pandemic, including both primary and secondary care.

It recommended that the NHS and Department of Health and Social Care better consider these difficulties in future pandemic planning, and that the NHS improve the data it holds on those with learning disabilities.

The report, published yesterday (12 October), was compiled jointly by the Health and Social Care committee and the Science and Technology committee.

It said: People with learning disabilities have experienced significantly higher death rates from Covid-19 than the country as a whole. Deaths have been especially high among younger adults with learning disabilities. Initial research suggests that people with learning disabilities entered the pandemic from a position of heightened vulnerability because of existing comorbidities.

‘This was compounded by particular barriers to accessing NHS treatment during the pandemic arising from restrictions on non-Covid care and limits on the ability of carers and advocates to attend hospital with people with learning disabilities.’

One of the witnesses in the inquiry, Steve Scown, chief executive of the learning disabilities charity Dimensions UK, told MPs that receiving their usual treatment was ‘much harder’ during the pandemic.

He said: ‘We have had instances where people we support have not been admitted to hospital because they are not deemed poorly enough, whereas in the past they would have been.

‘We have had difficulty getting GPs to visit. Often, the only way we have been able to access medical treatment is to dial 999.’

Earlier this year, a study found that almost half (46%) of 433 adults with learning disabilities who usually have an annual health check have not received one since the first lockdown in March 2020.

Existing inequalities

The authors of the Covid report added that ‘there was a high degree of consensus that existing inequalities, which pre-dated the pandemic, played an important role’, including greater rates of diabetes and obesity, which are both risk factors for Covid.

Drawing on evidence from the annual Learning Disability Mortality Review (LeDeR) Programme, which showed the average life expectancy for a man with learning disabilities was 61 – 22 years shorter than the general population, the authors suggested they ‘therefore entered the pandemic from a position of heightened vulnerability’.

The report suggested that given this risk, it would have been ‘desirable’ to make an earlier decision to prioritise this group for vaccination.

This decision was made in February, as the sixth priority group for vaccines was expanded to include everyone on the learning disability register.

However, the report’s authors added: ‘Implementing the decision was later hampered by a lack of data within primary care on patients with learning disabilities.’

Government made ‘serious errors’ responding to pandemic

More broadly, the investigation looked at six areas within the Government’s response – pandemic preparedness, lockdowns and social distancing, testing and contact tracing, social care, at risk communities and vaccines – and made 38 recommendations across these.

Its findings included that the UK’s response was ‘too reactive’ and showed ‘too little explicit learning’ from the international experience of the virus. It also stated the response ‘lacked speed in making timely decisions’.

The notable exception to these criticisms is the vaccine programme, which it said ‘reflected a collaborative approach’ between general practices, pharmacies and local NHS services.

In response to the report, BMA chair of council, Dr Chaand Nagpaul said: ‘The report gives well-deserved praise to the development and deployment of one of the most successful vaccine programmes in history, which was delivered largely by the hard work and dedication of doctors and healthcare staff.’

He added: ‘The way in which the Government abandoned social care, the inadequate provision and supply of PPE, and the lack of proper health risk assessment, especially for black, Asian and ethnic minority staff, forced health and care staff to put their lives at risk to protect their patients.’

The Government must learn from these mistakes ‘starting now’, he said, with the UK ‘continuing to be among the worst’ rates of infection, illness and death.

A broader public inquiry is set to follow this initial report into the UK’s Covid-19 response.