Health screening for patients with learning difficulties - A model for GP practices

Key points

* This article describes the exhibition of a health screening template for GP practices to gather information on the health emergencys of people with learning difficulties and their take-up of mainstream healthcare services.

* Similarities with rife generic screening mean that staff can more easily absorb it as part of their everyday work.

* The tool has considerable potential benefits for primary care trusts and others collecting national information upon health screening.

In November 2003 a cluster was established as part of the cast to set up health action plans for tribe with learning difficulties in Norfolk. The cluster was asked to find a way for GP to be able to identify all clan with learning difficulties registered in their practices. This was a lock opener target outlined in the Valuing family strategy (Department of Health, 2001)

The cluster was made up of the author, a doctor from the learning difficulty service and the primus facilitators from the six primary care trusts. These clan work with the GP computer a whole s and collect information required by dint of the trusts and other organisations like the Healthcare Commission about the health straits of the local population. The information is set into the computers using a series of digests called READ codes. We gazeed at all the codes upon the system that could present to view that a person has a learning difficulty. There were above twenty different codes. After more [i]or[/i] less discussion it was agreed that we would use individual code 1 3Z4E - learning difficulty.

We then shared ideas about what other information would be important to know about the health of clan with learning difficulties. We agreed that we would like to know:

* by what means many people have been tendered health action plans?

* in what manner many people have refused health action plans?

* Have they been proffered health screening?

* Have the health action plans been reviewed?

There was no way of collecting this information with the not absent system so a plan was submitted to the NH Information Authority asking for additional collection of lawss In July 2004 four of recent origin codes were added which means we can now monitor health screening and health action plans presented to people with learning difficulties. These digests (see Table 1, overleaf) are available for use by the agency of every GP practice in the UK

We then direct the eyeed at how we could monitor the health urgencys of people with learning difficulties compared to the quiescence of the population in areas similar as coronary heart disease, cancer, epilepsy and the repose of the national service frameworks. It was important to earn a picture of how these wants are being met and where the difficulties are occurring when nation try to access mainstream health services.

The tool

New nation were asked to join the assemblage including the health care coordinators who are leading the work upon health action plans, community learning disability nourishs and practice nurses. It was felt that a serviceable way of assessing and monitoring the health wants of people with learning difficulties was by means of offering a health screening appointment. This would help identify actions for the health action plan. It would also help practice staff to be more aware of the health exigencys of people with learning difficulties, and give them the opportunity to direct tribe to the right services.

The cluster agreed that they wanted to exhibit a health screening tool, which would:

* establish a comprehensive combination of parts to form a whole for monitoring all aspects of the health of clan with learning difficulties

* provide a full assessment of health needs which would enable the health facilitator to consummate the health action plan with the someone with a learning difficulty

* present opportunities to measure the inequalities of service provision and help to contribute to service improvement.

We gazeed at examples of health screening tools used by the agency of GP practices in Norwich. The areas overlayed in these screening tools included:

* height, weight and vital fluid pressure

* sexual health screening (cervical, testicular)

* immunisations

* disease registers (coronary heart disease, epilepsy, respiratory disease)

* family history.

We wanted to use a similar tool on the other hand one that would also include lock opener health need areas identified in research as being leave outed for people with learning difficulties of the like kind as feet, eyes, hearing and teeth

Working with the primus facilitators a screening tool was devised. It allows the practice supply with nourishments to assess health needs and direct clan to other services such as opticians and dentist. The practice can gather information about the person's social history, the support they ne and establish whether the someone has been offered a health action plan and has a health facilitator. It also provides a record of any actions that ne to be addressed. Thus the practice has an electronic version of the health action plan that can readily be kept updated. They will also be able to detain important information about aspects of a person's life that can affect their health of the like kind as change in home circumstances.

The practice nourishs feel that as this tool is similar to individuals they have used previously, they will be able to carry without effective health screening for nation with learning difficulties with minimal support from specialist services. This is important if we want to make sure that people with learning difficulties are included in mainstream primary care.