Learning disabilities: health checks, action plans and ethnicity
Indicator
The percentage of patients on the learning disability register, who:
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received a learning disability health check and had a completed health action plan in the preceding 12 months and
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have a recording of ethnicity.
Indicator type
General practice indicator suitable for use in the Quality and Outcomes Framework.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
People with a learning disability often have poorer physical and mental health, and higher rates of avoidable death. An annual health check can identify health concerns at an early stage and promote actions to address identified health needs such as vaccinations, blood tests, breast and testicular screening, dental review and vision and hearing assessment. The health action plan is an integral part of the requirements around a learning disability health check. Further guidance is available from NHS England on the provision of health checks and use of a national template. Patients should leave their health check with a copy of the action plan to support them in managing their health and wellbeing.
This indicator also requires a recording of ethnicity as increasing levels of premature mortality are noted in people with a learning disability from ethnic minority backgrounds.
Source guidance
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Care and support of people growing older with learning disabilities. NICE guideline NG96 (2018), recommendation 1.5.12
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Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges. NICE guideline NG11 (2015), recommendation 1.2.1
Specification
Numerator: the number in the denominator who:
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received a learning disability health check and had a completed health action plan in the preceding 12 months and
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have a recording of ethnicity.
Denominator: the number of patients on the learning disability register.
Calculation: Numerator divided by the denominator, multiplied by 100.
Exclusions: None
Personalised care adjustments or exception reporting should be considered to account for situations where the patient does not attend or declines the health check or health action plan.
Expected population size: QOF data for 2021/22 shows that an average practice with 10,000 patients would have around 55 eligible patients. To be suitable for use in QOF, there should be more than 20 patients eligible for inclusion in the denominator, per average practice with 10,000 patients, prior to application of personalised care adjustments. It should be noted that estimated prevalence of learning disability is substantially greater than currently reported in data for the QOF learning disability register. In 2019, NHS England published guidance to support improving the quality of the register.
ISBN: 978-1-4731-5952-5