by City University London

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Patients with learning disabilities experience significant barriers to accessing health care in England, according to a new study.

Analysis of national survey data shows that adult patients with learning disabilities have less confidence and trust in their health care professional or feel their needs are not met.

The study—led by Dr. Samuel Tromans, Associate Professor of Psychiatry at the University of Leicester, and involving Sally McManus, Professor of Social Epidemiology at City St George's, University of London and co-author of the paper—revealed that patients with learning disabilities (or their caregivers) 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 health care professional, or feel that their needs were met. The findings have 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 health care 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 health care 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 McManus added, "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. 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."

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 health care professional, or feel that their needs were met.

The study team would like to extend their thanks to the survey team (Ipsos MORI) for their generous assistance and support with this project.

More information: Samuel J. Tromans et al, Primary care experiences of adults reporting learning disability: a probability sample survey, British Journal of General Practice (2024). DOI: 10.3399/BJGP.2024.0056

A link to the GP Patient Survey website is here.

Journal information: British Journal of General Practice 

Provided by City University London