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People with learning disabilities missing out on annual health checks during Covid, study finds

by Rachel Carter
12 April 2021

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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, a study has found.

Research led by Warwick University is tracking the experiences of people with learning disabilities and their carers during the pandemic, including access to healthcare services.

The first wave of the study found that a similar number (48%) of 301 carers said the person with disabilities who they care for had also not received an annual check since the national restrictions came in.

The research included two groups of participants – 621 adults with learning disabilities (cohort one) and 378 family carers or paid support staff (cohort two).

It also found that where annual health checks had been carried out – for 29% of people in cohort one and 25% of people in cohort two – these were often carried out remotely, by video or telephone consultation (33% of cohort one health checks and 60% of cohort two).

The NHS Long Term Plan pledged to improve uptake of the existing annual health check in primary care to ensure that at least 75% of those eligible receive one each year.

In guidance on phase three of the Covid response sent to NHS organisations last August, NHS England said practices should ensure everybody with a learning disability is on their register, and that they have had their annual health check.

This is also one of six indicators included in the 2020/21 Investment and Impact Fund, introduced as part of the amended Network Contract DES.

NHS figures published in December 2020 show practices carried out 159,849 checks in 2019/20 – compared with 153,113 in 2018/19. This represents around half (51.9%) of the people with learning disabilities listed on the GP register.

‘Similar push’ to vaccinations needed

Chris Hatton, professor of social care at Manchester Metropolitan University and one of the researchers on the study, said that annual health checks were a vital way for people with learning disabilities to get the healthcare they need ‘now more than ever’.

‘People and families have told us that this has only happened for a minority of people through the pandemic, with many checks being done remotely,’ he said.

‘Primary care networks have been hugely successful in vaccinating people with learning disabilities for Covid-19 – a similar push needs to happen for effective health checks.’

Dr Richard Vautrey, BMA GP committee chair, said: ‘Given the disproportionate and often tragic impact that Covid-19 has had on people with learning disabilities, the BMA recognises the absolute importance of supporting the health of this group of patients.’

He added that practices were ‘working their hardest’ to reach patients who need them the most and that the BMA had agreed measures with NHS England to further support them to offer annual health checks, including through the new Investment and Impact Fund.

‘Likewise, the Government and NHS England must do more to encourage people with learning disabilities, especially as we approach the next phase of the pandemic, to take up the offer from practices for annual health checks, by providing appropriately tailored communications and information, and ensuring they are able to access the care they need,’ he said.

Access to healthcare professionals

The Warwick University research also found that 60% of people with learning disabilities in both cohorts one and two – who had routinely seen healthcare professionals before the first lockdown – had either seen them ‘less or not at all since then’.

Meanwhile, almost a quarter (23%) of adults in cohort one and 41% of those in cohort two have had a medical test or hospital appointment cancelled since the first lockdown in March.

Almost a third (30%) of family carers or support staff in cohort two also said that the physical health of the person they care for had deteriorated from the same period, the study found.

The study, which is tracking the experiences of people with disabilities during the pandemic over a 12-month period, will now carry out two further waves of data collection.

The findings come after a Public Health England report revealed last year that people with disabilities were up to six times more likely to die from Covid.

In February, GPs were told to invite all patients on the learning disability register for Covid vaccination as part of priority group six.

Last month, NHS England also published its new policy for the Learning Disability Mortality Review programme (LeDeR), which includes people with autism for the first time.