Academic Unit of Primary Care LEEDS INSTITUTE OF HEALTH SCIENCES

1. Academic Unit of Primary Care LEEDS INSTITUTE OF HEALTH SCIENCES Patient and Carer Perspectives of Annual Health Checks in General Practice for People with Learning Disabilities Jessica Maddams1, David Pearson2 1Leeds Medical School, University of Leeds 2Academic Unit of Primary Care, Leeds Institute of Health Sciences, University of Leeds • Introduction • People with learning disabilities have greater health needs than the general population but there is concern that mainstream primary care services fail to meet their complex needs.1 • To address this shortfall, the government has introduced annual health checks for adults with learning disabilities in general practice, as a Directed Enhanced Service (DES).2 • International research has confirmed the health benefits of annual health checks but has failed to incorporate the views of people with learning disabilities and their carers. 3,4 • Annual health checks will only prove cost-effective and confer long-term health benefits if service users and carers are engaged in the process. • Aim • To ascertain the experiences, expectations and opinions of people with learning disabilities and their carers with regards to a newly implemented annual health check in Robin Lane Medical Centre, Pudsey. • Methods • NHS ethical approval was obtained for a mixed qualitative study including: • semi-structured interviews with service users • a focus group of carers of people with learning disabilities. • Convenience sampling identified six service users for interview and four carers to take part in the focus group. • Participants were asked to offer their perspectives on their participation in a recent annual health check, identify any concerns and suggest improvements. • Audio data was transcribed and analysed using thematic analysis. • Principal findings and implications • More Information • Participants would benefit from more information on the purpose of annual health checks to assist their understanding and help to ease service user anxiety. • 2. Follow-up • Participants raised concerns about follow-up after the annual health checks. Carers should be provided with a summary of annual health check findings to help them co-ordinate the care of service users. • Communication Skills • Participants reported that communication skills varied between healthcare professionals. Communication skills training would help to build confidence in consulting with people with learning disabilities and promote triadic communication. • 4. Continuity • Continuity was considered beneficial to the care of people with learning disabilities. Annual health checks should be carried out by one doctor and nurse team, where possible. • Conclusions • It is possible for people with learning disabilities to make a valuable contribution to qualitative research. • Future research and general practices should acknowledge this by engaging service users and their carers in evaluating annual health checks in the future. • Other practices engaged in the learning disabilities DES might wish to consider how the suggestions made by this study group are applicable to their own practices and patient populations. References DEPARTMENT OF HEALTH. 2001. Valuing People, a new strategy for learning disability for the 21st century. London: The Stationary Office NHS EMPLOYERS. 2010. Clinical directed enhanced service (DESs) for GMS contract: guidance and audit requirements for 2010/11 [online]. [Accessed 24/09/10]. Available from: http://www.nhsemployers.org/Aboutus/Publications/Documents/Clinical_DES_guidance_2010.pdf LENNOX, N., C. BAIN, T. REY-CONDE, D. PURDEL, R. BUSH, and N. PANDEYA. 2007. Effects of a comprehensive health assessment programme for Australian adults with intellectual disability: a cluster randomised trial. International Journal of Epidemiology. 36, pp. 139-146 COOPER, S-A.,J. MORRISON, C. MELVILLE, J. FINLAYSON, L. ALLAN, G. MARTIN, and N. ROBINSON. 2006. Improving the health of people with intellectual disabilities: outcomes of a health screening programme after 1 year. Journal of Intellectual Disability Research. 50(9), pp. 667-677 Jessica Maddamsum06jjm@leeds.ac.uk Dr David PearsonD.J.Pearson@leeds.ac.uk