Worries remain over learning disability services in GP consortia
26 July 2012
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.
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