Patients with learning disabilities experience significant barriers to accessing healthcare in England, according to the results of a study published online in the British Journal of General Practice earlier this month (7 October).
Analysis of national survey data shows that adult patients with learning disabilities have less confidence and trust in their healthcare professional or feel their needs are not met.
The study, led by Samuel Tromans, associate professor of psychiatry at the University of Leicester, compared the characteristics and primary care experiences of adults reporting learning disability with those who did not.
The researchers found that patients with learning disabilities (or their carers) find it hard to navigate their GP’s website easily and were twice as likely to have a preferred GP. They were also less likely to have confidence in their healthcare professional or feel that their needs were met.
Ease access to primary care
Data for the study came from an analysis of the 2022 General Practice Patient Survey of people registered with NHS primary care in England (conducted by Ipsos Mori), in which 6,711 reported having a learning disability out of 623,157 participants aged 16 years or over.
Dr Tromans said: ‘More needs to be done to ensure ease of access to primary healthcare for patients with learning disabilities. This includes being able to see their preferred GP and longer consultation times, so that their needs are provided for and they have time to discuss their health issues.
‘Patients with learning disabilities are at increased risk of mental and physical health conditions such as epilepsy, visual and hearing impairment and asthma and have a significantly reduced life expectancy. Having unmet healthcare needs adds to this, such as reduced uptake in potentially lifesaving screening tests like cervical cancer.’
High rate of ‘avoidable’ deaths
The study cites the 2022 Learning from Lives and Deaths – people with a Learning Disability (LD) and Autism (LeDeR) report, which describes an average age of death of 62.9 years for both adult males and females with learning disabilities in England in 2022, compared to 86.1 years for adult females and 82.6 for adult males without learning disabilities in the general population, with 42 per cent of deaths deemed avoidable.
Co-author Terry Brugha, a professor of psychiatry at the University of Leicester, said: ‘In order to improve outcomes health professionals need higher quality training and to put in place reasonable adjustments in clinical settings to allow for better patient communication.
‘Moreover, pharmacists could also provide an invaluable point of intervention for adults with learning disabilities due to a high tendency for them to visit their pharmacist prior to making a GP appointment.
Professor Brugha noted: ‘There is also a need to improve accessibility of practice websites for adults with learning disabilities, perhaps through patient and public involvement in website development and accessibility evaluations.’
However, he added that more data are needed to better understand why adults reporting learning disabilities were less likely to have confidence and trust in their healthcare professional, or feel that their needs were met.
In order to improve outcomes health professionals need higher quality training and to put in place reasonable adjustments in clinical settings to allow for better patient communication [Terry Brugha]
Sally McManus is a professor of social epidemiology at City, University of London and another co-author. She said: ‘This study is one of the largest of its kind. The research is particularly powerful because it can compare people with and without learning disabilities.
Professor McManus added: ‘Those with learning disabilities face so many additional challenges – including poorer health and fewer resources. Primary care really should be more, rather than less, accessible for this group.’
The study team thanked the survey team (Ipsos MORI) for their assistance and support with this project. To follow a link to the GP Patient Survey website, click
To access the full version of the accepted article – titled Primary care experiences of adults reporting learning disability: a probability sample survey – click
