Study highlights barriers to healthcare for patients with learning disabilities

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 Dr Samuel Tromans, Associate Professor of Psychiatry at the University of Leicester, revealed that patients with learning disabilities (or their carers) find it hard to navigate their GP 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.  The findings have now been published in the British Journal of General Practice.

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.”

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 LD in England in 2022, compared to 86.1 years for adult females and 82.6 for adult males without LD in the general population, with 42% of deaths deemed avoidable. 

Professor of Psychiatry Terry Brugha from the University of Leicester, a co-author on the study, 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.

“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 was 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.

 Angela Hassiotis is Professor of Psychiatry of Intellectual Disability at UCL Division of Psychiatry and co-author of the paper.

She added: “People with a learning disability face multiple disadvantages and reduced life expectancy. Our study shows that primary care is seen as difficult to access and not trusted by a very vulnerable population group. Whilst this may not reflect experience in all areas it gives an important indicator for NHS services to be more equitable and accessible. Closer working relationships with learning disability specialist services and awareness of the increased health risks and practical adjustments are some of the steps needed to promote and maintain better health in people with a learning disability.”

The study team would like to extend their thanks to the survey team (Ipsos MORI) for their generous assistance and support with this project. A link to the GP Patient Survey website is here - https://gp-patient.co.uk/