News last week that the number of adults with learning disabilities receiving an annual health check has risen to 50% is good, but it still means that half of them aren't getting a check that they are entitled to. And this is additionally worrying given the planned introduction of GP consortia. The figures, collected by the Department of Health and published by the Improving Health and Lives Learning Disabilities Observatory, found an 8% rise, year-on-year, in the number people with learning disabilities having the health check they are entitled to. To me, that isn't much of an increase. This was the third year that the health checks should have been available, so GP practices have had more than enough time to get their collective act together on this. However, like so many other aspects of learning disability care, how good your treatment is depends on where you live - and if you're lucky enough to have a GP practice with someone who takes an interest in learning disabilities. As professor Jan Walmsley noted in a recent article in Learning Disability Today, the key to success is often effective leadership within a practice - someone who takes on responsibility for health checks and devises a way of undertaking them and puts systems in place to ensure patients with the practice, know about the checks. But all too often this doesn't happen. As Professor Eric Emerson, co-director of the National Specialist Learning Disabilities Public Health Observatory, noted, coverage rate in the bottom 10% of primary care trusts (PCTs) is 24% or less. That's a lot of GP practices that don't do many health checks. While it isn't solely down to GPs to ensure people have health checks - other professionals working in PCTs and in learning disabilities need to encourage service users and carers too - it does make one worry about what will happen when GPs take over commissioning of services. Would this sort of statistic be replicated in other areas of healthcare? Ever since the government announced plans for GP consortia last year, one of the main fears has been that specialist services, such as those for people with learning disabilities, could suffer. While the decision to include hospital doctors and nurses in consortia is welcome, there are still fears that if there isn't, for example, a champion for people with learning disabilities, then they could lose out on the specialist services they need. Worries such as this - and it isn't just within learning disabilities, other specialist areas of healthcare, such as mental health, have similar concerns - need to be addressed before GP consortia are operational. For me, specialists in learning disabilities should be involved in every consortium, if not as a direct part, at least in some sort of a consultancy role. As the take-up for health checks proves, there isn't the knowledge among GPs, about learning disabilities, for them to be able to commission services effectively on their own.