The Royal College of Physicians (RCP) has launched a new acute care toolkit to help address the suboptimal care provision for people who have a learning disability.

The College said that people with a learning disability experience worse patient safety outcomes and quality of care in hospital and the toolkit aims to address clinical challenges such as delayed presentation, communication, behaviours of distress and diagnostic overshadowing.

Key recommendations in the toolkit include using primary care records/hospital alert system to help identify, on admission, all patients with a learning disability, and ensuring reasonable individualised adjustments in communication and care are made.

The toolkit also acknowledges that the clinical presentation of a person with a learning disability can be highly variable as multiple health conditions and polypharmacy are common at a young age. Therefore, a specific focus on assessing and meeting the care needs of these patients is required as people with a learning disability may die of common and preventable conditions.

It also states that healthcare staff should involve the person with a learning disability – and, where appropriate, their carers – in decision making as much as possible. It adds that staff should assess mental capacity for each decision and use the hospital learning disability team as a resource in guiding decisions around care.

Inequality of people with a learning disability must be addressed as a priority

Dr John Dean, improvement clinical director at the RCP, who led on the creation of the toolkit said: "Approximately 2% of the adult population has a learning disability. We know their care can be compromised when admitted to hospital resulting in significantly worse outcomes and experience.

"This inequality must be addressed as a priority. The toolkit gives a simple guide to clinical staff on how to give appropriate care in these circumstances, and has the potential to make a big difference."

The RCP worked with NHS England and Improvement (NHSE/I) and the Society for Acute Medicine on the development of the toolkit with valuable input from people with lived experience of learning disabilities.

The toolkit contains:

  • Top tips on caring for people with a learning disability
  • Guidance on reasonable adjustments
  • Features of acute presentations of people with a learning disability
  • Considerations for the treatment of common medical problems in this patient group
  • Medicolegal and safeguarding considerations
  • Recommendations for quality improvement and education.

The Acute care toolkit was supported by funding from NHS England Learning Disability and Autism Programme.

An Easy Read version of the toolkit is also available.