Resources for Learning Disability Annual Health Checks and Health Action Plans

Overview

On this page you will find a range of resources and links to websites to help you and your practice carry out Annual Health Checks (AHC) and create a health action plan (HAP).

CKS Nice https://cks.nice.org.uk/topics/learning-disabilities/ Covers diagnosis, management including AHC and behaviour that challenges.

Annual Health Check

People with learning disabilities have poorer health outcomes compared to the general population. The annual health check (AHC) promotes health and wellbeing and can identify problems early.

• AHC Minimum requirements under the DES
• AHC step by step guide to AHC for health care professionals (This is a download of the old RCGP Annual Health Check Toolkit.  There is currently no date when the updated toolkit will be available.)
• AHC step by step health check toolkit national development team for inclusion
• Cardiff Health check template
• How to Complete an Annual Health Check

We recommend the use of the emis AHC template “Learning disabilities annual health check “or the Ardens® template “ learning disability” to help with a structured assessment.

Syndrome specific checks

People with genetic syndroms including Down’s -, Rett-, William-, Noonan-, Fragile X-, Angelman- and other syndromes need additional tests at the AHC.

• Syndrome specific checks at the AHC

Pre-health Check

• EASY READ invitation: BNSSG Annual Health Check Invitation template
• Create personalised easy read appointment letter for free using Easy Read Appointment Letter Tools - Lincolnshire
• Pre-AHC check list for patients / supporters:
  • Healthwatch BNSSG LD AHC Checklist to send / give to patients prior to health check
  • EMIS Preparation checklist for AHC

Reasonable Adjustments

It is a legal duty to provide patients with reasonable adjustments so they can access health care the same as the general population.

It is good practice to document reasonable adjustments in the medical records. This will help with every patient contact and with annual recall for health checks, vaccination and chronic disease monitoring.

• A for Adjustment - adjusted care resources to support health and care workers
• Link to reasonable adjustment infographic
• Top tips reasonable adjustments for clinicians
• Reasonable Adjustments Poster (Sirona)
• Reasonable adjustments television slide for people attending GP practices.

Health Action Plan

A Health Action Plan (HAP) must be produced as a result of the AHC outlining any actions and outcomes including recommendations on health promotion and wellbeing. The HAC plan is reviewed at the next AHC and progress monitored.

Following Health action plans are available in emis under documents:

• ICB BNSSG Health Action Plan for Learning Disabilities
• EMIS Learning Disability Annual Health Check Action Plan
• Ardens Learning disability Health Action Plan V15.5 (short and easy to use)
• Ardens Learning Disability Health Action Plan-Long V16.9 (pulls in a lot of information from EMIS)
• How to complete a Health Action Plan

Promotion of annual health checks

Autism Independence have produced posters in various languages to be used in GP practice waiting areas. The posters detail support that they provide for people with a learning disability to access their annual health check.

• English poster
• Arabic poster
• Polish poster
• Somali poster
• Urdu poster

Feedback

You might want to ask for feedback after the annual health check.  Click here to access the Annual Health Check Patient Feedback Form from Southern Health.

Learning Disability Register and Coding

It is good practice to review and update the GP learning disability register. Add the code “learning disability” or on the learning disability register”. You do NOT need an expert opinion or specialist assessment before adding a patient to your register. You can use the Leeds inclusion toolkit if you are unsure if a patient should be added to the register.

• Improving and Updating your Learning Disability Register (short summary guide)
• Improving Identification of Learning Disability  - Guidance for GPs
• AHC Coding Guidance 
• Leeds learning disability inclusion toolkit 
• New on the Learning Disability Register (patient information leaflet EASY READ)
• Learning Disability Register - Children (patient information leaflet EASY READ)

Transition

Here are resources to help you support the transition of patient on the learning disability register from paediatric to adult services. Your best tool is an up-to-date learning disability register and inviting young people from the age of 14y for annual health checks.

• Transition top tips
• Link to RCGP transition learning module https://elearning.rcgp.org.uk/course/view.php?id=485 (requires RCGP log in)
• Click here to access the letter to send to parents/carers of a young person about the annual health check.
• Click here to access the letter a young person can write to their GP surgery to introduce themselves.

Support

Join the network of learning disability champions. Anyone, if clinician or administrator can join. Email: sirona.ldchampions@nhs.net.

We are running regular learning disability lead GP forums and send out a learning disability newsletter. To get on our mailing list contact sirona.ldchampions@nhs.net

The Sirona Learning Disabilities Health Service

BNSSG Annual Health Check Team:

Juliane Matthies - GP Clinical Lead for Learning Disabilities BNSSG: juliane.matthies@nhs.net

Further Resources for Annual Health Checks

Videos for health care professionals and people with learning difficulties and their supporters about AHC from NHS England and NHS Improvement South West - Please see this document for full details.

AHC resources for health care professionals, carers and people with learning disability - NDTI health-check-resources-guides.

NHS England guidance including easy read resources: https://www.england.nhs.uk/learning-disabilities/improving-health/annual-health-checks/.

The west of England learning disability collaborative has excellent educational videos on many aspects of the annual health check, care planning, capacity/consent and oral health.

BNSSG Annual Health Check promotion video - BNSSG ICB commissioned the video with learning disabled actors to promote Annual Health Checks. It is designed for GPs to text to LD patients as a reminder to book an appointment. Text link is: https://youtu.be/dGITBtSSEGo

AUDIT / QUIP

Self-assessment toolkit for GP practices round AHC and reasonable adjustments: GP self assessment

Learning Disability and Autism Newsletter

LD Newsletter - October 2023

LD Newsletter - March 2023

LD Newsletter - January 2023

LD Newsletter - October 2022

LD Newsletter - June 2022

Other Resources

Appointment Card

These are examples of an easy read appoint cards that can be edited:

• Example 1
• Example 2 (short)

Blood Tests

• https://www.gov.uk/government/publications/blood-tests-and-people-with-learning-disabilities/blood-tests-for-people-with-learning-disabilities-making-reasonable-adjustments-guidance

Complaints

• EASY READ Example practice complaints leaflet

Cancer and Screening

• Please see the LD & Cancer Screening page on Remedy for advice on screening and EASY READ resources.

Constipation and Fibre 

• EASY READ Constipation resources
• A4_Patient_Leaflet_20.4_AW_1_a.indd (england.nhs.uk) easy read for patients
• Constipation resources for carers and families
• A4 Carer Leaflet Tackling Constipation (england.nhs.uk) accessible format
• Fibre food fact sheet from the Association of UK Dieticians. NOT easy read: https://www.bda.uk.com/resource/fibre.html
• Patient Information Video on Constipation 4:23
• What are the signs of constipation? - YouTube 0:39 patient information video
• Bristol Stool Chart (england.nhs.uk) accessible
• Constipation resources for HCPs

Eyes and Vision

SeeAbility support people with LD / autism and sight problems. Their website has a function to look for a local optician with expertise in people with learning disability.

Epilepsy

• Epilepsy action has a learning disability friendly section https://www.epilepsy.org.uk/info/carers/learning-disabilities/easy-read-and-audio
• Main website https://www.epilepsy.org.uk/
• Epilepsy society ( not easy read) epilepsysociety

Flu

• EASY READ guides providing information on influenza (flu) and vaccination
• NHS Easy Read Poster:  flu vaccination leaflet 
• NHS Easy Read Leaflet:  protect yourself from Flu poster
• NHS Flu vaccination video for people with a learning disability
• NHS Flu vaccinations video for carers
• Misfits Theatre Company video tackles flu vaccination misinformation
• Camilla attends her flu jab appointment in this video
• A number of simple text resources are available for downloading/ordering

General Resources for Patients and Supporters

• Website made by people with learning disabilities about how to keep healthy http://www.advocate4health.org.uk/index.php
• Hertfordshire examples for people with LD – how to stay healthy inc breast and testicular examination, constipation, cancer etc. https://www.hertfordshire.gov.uk/services/adult-social-services/disability/learning-disabilities/my-health/how-to-stay-healthy.aspx
• Easy health. Easy read leaflets and videos: https://www.easyhealth.org.uk/ (Access to most resources by membership only, membership is free)
• A picture of health are easy read leaflets and videos on many health issues Home | A Picture of Health | Making Health Information Easier (southwest.nhs.uk)

Healthy Lifestyle, Exercise and Diet

• A picture of health: http://www.apictureofhealth.southwest.nhs.uk/ EASY READ information on large number of health topics including healthy lifestyle
• Sirona library has a EASY READ section on diet and nutrition: http://www.sirona-cic.org.uk/advice-information/leaflet-library/nutrition-and-dietetics/easy-read-information/
• Patient webinars on nutrition for a variety of health conditions including constipation and Obesity: https://patientwebinars.co.uk/
• Snack swab documents: fat swap, sugar swap and snack swap docs
• EASY READ 12 month challenge workbook

Heat Safety

• Heat Wave Easy read

Mental Capacity Assessments and Best Interest decisions in Primary Care

• section on Remedy is here.

Respiratory

• My Asthma Plan

Pain scales and body maps

Leeds Team have developed the excellent "Let me tell you about my pain" booklet with non-verbal communication tools and body maps

Wong-Baker FACES^® pain rating scale

Non-Communicating Adult Pain Checklist

Sepsis

• EASY READ - How to avoid Sepsis
• EASY READ - Signs of Sepsis and what to do
• EASY READ - Problems after Sepsis

Swallowing Difficulties

• Swallowing Difficulties - help and advice for patients and healthcare professionals includes tool to find alternative formulations.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.