This section provides practical advice about relevant clinical skills. Most advice is written, but pictures also feature, including some from the Books Beyond Words series. See also:
Learning Disabilities and Homelessness. This toolkit is a starting point in working towards good practice in supporting people with a learning disability, and signposts to further information and resources. https://homeless.org.uk/knowledge-hub/learning-disabilities-and-homelessness-toolkit and https://groundswell.org.uk/wp-content/uploads/2022/05/Learning-Disabilities-Toolkit-.pdf
RCP Training Programme to meet the Medical Needs of Adults with a Learning Disability https://www.rcp.ac.uk/education-practice/courses/training-programme-meet-medical-needs-adults-learning-disability
Learning Disability Training in Primary Care Module https://www.lmc.org.uk/learning-disability-training-in-primary-care.html
Animation around the challenges of people with learning disabilities in primary care: Short film based on real-life experiences of people with a learning disability, exploring their experience of accessing Primary Care services, and Annual Health Checks in particular. https://www.youtube.com/watch?v=_ZGIG_RrTuc
Capacity Guide: comprehensive guidance for clinicians and social care professionals on the assessment of capacity https://capacityguide.org.uk/
https://mentalcapacitytoolkit.co.uk/ The toolkit to help support professionals working with individuals whose decision-making capacity is limited, fluctuating, absent or compromised
The General Medical Council consider effective and sensitive communication to be one of the "essentials of basic clinical method". "Doctors must be good listeners if they are to understand the problems of their patients and they must be able to provide advice and explanations that are comprehensible to patients and their relatives".
Nutritional well-being is recognised as an important factor in maximising growth potential, maintaining health, and improving quality of life and longevity.
Books Beyond Words are full-colour picture books that address some of the problems in understanding experienced by people with intellectual and communication difficulties.
Advice for medical students and GPs
In the past few years, more than 1,000 future doctors at St. George's, University of London, have benefited from training by actors with intellectual disabilities.
We have designed a leaflet to help men with learning disabilities to learn more about their balls (testicles) and how to look after them. It is important for every man to check regularly and to see his doctor immediately if he finds any changes.
A&E is generally a strange and unfamiliar environment for anyone. For persons with intellectual disabilities, the experience may be particularly scary because they may not understand what is happening around them.
This technique facilitates positive engagement with children and adults, many of whom are on the autistic spectrum, and with whom communication is often difficult.
Advice for medical students and staff in Accident & Emergency units.
Interview with Jim Blair, Consultant Nurse in Learning Disabilities, by Alexander Chiu, Final Year Medical Student at St George’s University of London, and Dr Jason Tsang, Foundation Year 1 Doctor
Welcoming a patient with Intellectual Disabilities into General Practice: Reasonable Adjustments in Primary Care
An examination of reasonable adjustments in order to reduce health inequalities for people with learning disabilities. Although written in the context of the UK, the principles expressed are valid internationally.
Everybody’s life has worth – Getting it right in hospital for people with an intellectual disability and reducing clinical risks
This article addresses the need for reasonable adjustments, and other issues, by using examples of a hospital passport, assessing the mental capacity of a person, and how to improve care provided and reduce clinical risks for people with intellectual disability.
This article is based on hospital experiences described by people with learning disabilities and includes suggestions provided by them as a result of sharing their ideas and experiences.
The following presentations, one for adults and one for children/young people, can be adapted for use by a variety of healthcare organisations, by inserting the relevant information and contact details in the boxes provided.
People with intellectual disabilities have poorer health than the general population and therefore Annual Health Checks have been introduced to improve this situation. This article highlights the reasons for the checks, the preparation involved for practice staff and the check itself.
Many people with learning disabilities are not getting their annual health check, facing increased risk factors to a number of diseases as a result. This article considers what more can be done to help those most at risk.
Parents who are all experts by parental experience, talk about their experiences with health professionals, both positive and negative, and what would really help them and their children. Jim Blair provides summaries and suggestions for improvements for these families.
Refocusing: what you see isn’t all there is – getting healthcare right in hospitals for autistic and learning disabled people
Significant changes in how autistic people with a learning disability access and experience healthcare can and should be informed by stakeholders, including the patient and their family. This article provides different examples and suggestions from experts by parental experience.
The Health Equalities Framework (HEF): Prioritising clinical decisions and supporting the measurement of outcomes for people who have intellectual disabilities
There is increasing evidence that use of the Health Equalities Framework (HEF/HEF+) can positively influence timely and prioritised approaches that improve health and social outcomes for people who have intellectual disabilities.
The aim of Responsive Communication is to address deficits in both Functional Communication and Emotional Engagement. This article follows an earlier paper on Intensive Interaction, using body language to get in touch with children (and adults) with whom we struggle to interact.
A tool that ensures care is safe, clean and personal every time was adapted for learning disability settings, leading to improvements in care.
People with learning disability experience massive health inequality, so the role of GPs is vital in addressing this fundamental problem. Annual health checks are a very important part of this process.
In all areas of health care or social care, it is likely that you will encounter people with an intellectual disability, and it is essential to understand the principles of consent as applied to this population.
This presentation was part of a panel discussion at the Psychiatry of Intellectual Disability Spring Conference of the Royal College of Psychiatrists, held in April 2022.