Improving the uptake and quality of annual health checks for young people with learning disability
Compared to the general population, people with learning disabilities (LD) have poorer physical and mental health. People with LD also die younger and are more likely to die from treatable health conditions compared to people without LD (LeDeR report, 2018). The NHS Long Term Plan and NICE Guidelines NG54, QS142 and QS187 recommend Annual Health Checks to improve outcomes for young people with learning disabilities. A parallel policy as part of Special Educational Needs and Disabilities reforms recommends health information is included in Education and Health Care Plans. Annual Health Checks help to detect and manage health conditions early, review current treatments are appropriate, and help to build continuity of care (Buszewica et al., 2014). They result in increased investigations, identification of both physical and mental health disorders, medication reviews and appropriate referrals to secondary care in adults with LD. Current data indicate that the uptake of Annual Health Checks in young people with LD aged 14-17 is particularly low at 37%, and lower than adults aged 18+ (58%; gov.uk 2018/2019).
Policy and Practice Partners:
Aims and Objectives:
To improve uptake and quality of Annual Health Checks in children and young people (CYP) with LD aged 14-17 attending a severe learning disabilities special school. An integrated care model between primary care and education (school health and education professionals) services will be developed and implemented, improving uptake and quality.
Stage 1: Public Patient Involvement (ongoing)
We have conducted focus groups and interviews with 13 parents of CYP with LD, four CYP with LD, and a range of healthcare professionals working with people with LD (general practitioners, community paediatricians, special school nurses, clinical psychologists) and education professionals from severe learning disability special schools (headteachers and deputy headteachers).
We will continue to involve members of the public (parents/carers of CYP and CYP with LD) as well as education and healthcare professionals (primary care, secondary care, special school clinical staff) in the development of an intervention model.
Stage 2: Intervention development
The intervention model has not yet been fully developed as consultation is ongoing. It is envisaged that a systems-based intervention that fits within existing infrastructure will be co-designed with stakeholders.
Stage 3: Pilot Feasibility Study
Once the intervention model has been developed, funding will be sought from NIHR Research for Patient Benefit to conduct a pilot feasibility trial in two local severe learning disability special schools. The schools have been involved in the PPI work conducted to date and have agreed to take part in future research.
Implications for Implementation: