People living with learning disabilities: Access to health and social care

Approximate read time: 10 minutes

The House of Lords is scheduled to consider the following question for short debate on 26 March 2026:

Lord Scriven (Liberal Democrat) to ask His Majesty’s Government what assessment they have made of (1) the use of reasonable adjustments for, and (2) the safety of, people living with learning disabilities when accessing health and social care.

Health and social care is devolved in the UK. This briefing focuses on care provided for people with a learning disability in England.

1. Background: What is a learning disability?

Public Health England define someone with learning disabilities as having:

• a significantly reduced ability to understand new or complex information and to learn new skills, this is known as impaired intelligence
• a reduced ability to cope independently, this is known as impaired social functioning.^[1]

It states that these disabilities will have begun before adulthood and have had a lasting effect on development.

The specific cause or causes why someone may have a learning disability are not always known.^[2] The causes can include complications during a mother’s pregnancy or during birth, genetic changes that make having a learning disability more likely, illnesses or injury in childhood, and certain health problems, such as spina bifida, that affect a baby’s development. Some health conditions mean that someone may be more likely to have a learning disability. As NHS England notes:

For example, everyone with Down’s syndrome has some level of learning disability, and so do many people with cerebral palsy. Some people with epilepsy also have a learning disability and so do many autistic people.^[3]

A learning disability is different for everyone and the types of support required varies.^[4] Some people may need support throughout their lives, while others have a greater degree of independence meaning they can work, have relationships and live alone.^[5] While a learning disability will last a person’s whole life, many people with a learning disability can develop new skills throughout their lives.^[6]

Learning disabilities do not include learning difficulties such as dyslexia. However, the care someone with a learning disability may need would also need to support a learning difficulty if they have one. They may also be neurodivergent; for example, they may have attention deficit hyperactivity disorder or be autistic.

2. Learning disability and health inequality

As the House of Commons Women and Equalities Committee noted in its 2024 report ‘Inequalities in healthcare and employment for people with a learning disability and autistic people’, people with a learning disability “face significant health inequalities, including an unacceptable level of premature and avoidable deaths compared to the general population”.^[7] In its most recent report on the life expectancy of people with a learning disability, King’s College London found that people with learning disabilities died 19.5 years younger on average than the general population.^[8] The report also noted the rate of avoidable deaths for adults with a learning disability had fallen from 46.3% in 2021 to 40.2% in 2023. However, it remained nearly double the rate of avoidable deaths for the general population (21.8%).

The Care Quality Commission (CQC) states that people with a learning disability are less likely to access and participate in preventative care, screenings, vaccinations and other treatments.^[9] They are also more likely to experience severe mental illness and have higher rates of conditions including dementia, respiratory diseases and complex health conditions. A further cause identified for health disparity is ‘diagnostic overshadowing’, where potential symptoms are wrongly assumed to be because of someone’s disability, resulting in delays to treatment and diagnosis.^[10]

In January 2026, the Cabinet Office Disability Unit and the Office for Equality and Opportunity published a report on the social care and support provided to disabled people in the UK.^[11] It made several recommendations, including that it was important that the social care and support provided to disabled people—including people with a learning disability—was personalised to their specific needs. It also noted the importance for people with a disability of meaningful and positive relationships with personal assistants and care staff. However, it recognised that the quality of these relationships was often subject to issues including staff workloads, high staff turnover and a lack of training.

3. Measures intended to improve health and social care provision

In its ‘10-year health plan for England’, published in 2025, the government committed to reducing health inequalities, including for people with a learning disability, and improving preventative care.^[12]

The rest of this section highlights several of the measures introduced by previous governments and the current government intended to reduce health inequality for people with a learning disability.

3.1 Reasonable adjustments

Under the Equality Act 2010, public sector organisations must implement reasonable adjustments to ensure the services they provide are accessible by people who have a disability.^[13] This is also required by the health and adult social care regulator, the CQC.^[14]

Reasonable adjustments will vary depending on an individual’s needs but can include providing written information in an ‘easy read’ format and offering longer appointments if someone needs more time to help them understand the information they are being given.^[15] It may also include working with support workers, family members and/or a specialist learning disability liaison nurse.

3.2 Reasonable adjustment flag

NHS England and NHS Digital have developed a ‘reasonable adjustment flag’ (also referred to as the ‘reasonable adjustment digital flag’).^[16] This is an England-wide record intended to ensure that any reasonable adjustments someone might need are recorded and accessible across the NHS. The flag is intended to be visible on someone’s records when a patient is referred or is presented for care.

The creation of a digital flag was originally included in the 2019 ‘NHS long term plan’.^[17] The current government has committed to continue the roll-out of the digital flag.^[18] In December 2025, the government published an updated reasonable adjustment digital flag information standard which set out what information should be included and how it should be maintained.^[19] Providers are required to be compliant with this standard by 30 September 2026.

3.3 GP learning disability register and annual health checks

Most GP surgeries in England maintain a learning disability register listing those patients with a learning disability.^[20] People over the age of 14 on these registers are entitled to an annual health check.^[21] The current guidance for GP services on improving the identification of people with a learning disability was published in 2019.^[22]

The government has committed to increase the number of people on general practice learning disability registers and receiving annual health checks.^[23] Mencap has also called for GPs to prioritise ensuring people with a learning disability are registered on the learning disability register.^[24]

In October 2025, Secretary of State for Health and Social Care Wes Streeting wrote a joint letter with Mencap to GPs encouraging them to ensure everyone eligible should be included in learning disability registers and in receipt of annual health checks.^[25] The letter noted that the people most likely not to be registered were those with a mild learning disability, and people from Black, Asian and minority ethnic backgrounds.

3.4 Mandatory training for health and social care staff

Under the Health and Care Act 2022, health and social care providers registered with the CQC are required to ensure their staff receive appropriate learning disability and autism training.^[26] The government’s preferred training model is the ‘Oliver McGowan mandatory training on learning disability and autism’, published in June 2025.^[27] This training was named after a teenager who died in 2016 after having a severe reaction to medication given to him against his family’s wishes. In November 2025, the government said over three million people had completed the e-learning package, the first part of this training.^[28]

3.5 Other measures

The following measures are also intended to support and improve the care provided for people with a learning disability:

• NHS England has set out expected standards for the care provided by NHS trusts to people with a learning disability.^[29]
• Integrated care boards (ICBs) are required to have an executive lead for learning disability and autism.^[30] The executive lead is responsible for providing oversight and accountability for tackling health inequalities.
• In October 2025, NHS England issued the medium-term planning framework.^[31] Under this framework, ICBs are required to set out in their five-year strategic plans how they will reduce the health inequalities faced by people with a learning disability and autistic people within their local populations.
• In addition to duties under the Equality Act 2010, ICBs are also required to have regard to the need to reduce health inequalities under the NHS Act 2006.^[32] Advice on how ICBs should meet these requirements is set out in the ‘Statement on information on health inequalities’.^[33] The most recent statement was published in November 2025.
• NHS England’s wider scheme for reducing health inequalities, including those experienced by people with a learning disability, is the Core20PLUS5 programme, launched in 2022.^[34]

4. Care Quality Commission: Annual report

In October 2025, the CQC published its annual report on the state of health care and adult social care in England.^[35] The CQC noted that, as at March 2024, only about a quarter of the around 1.3 million people with a learning disability in England were recorded on their GP’s learning disability register. It also noted, for about 12% of those registered, that their GP practices did not provide annual health checks. On the provision of reasonable adjustments, the CQC noted:

Through our focus groups, autistic people and people with a learning disability told us that they are not consistently offered reasonable adjustments as their needs were not recorded in their records. This put the onus on them to ask for reasonable adjustments or to arrange adjustments for themselves, and they sometimes lacked the confidence to do that.^[36]

5. Read more

Parliamentary material

• Oral question on ‘Learning disabilities mortality review reports’, HL Hansard, 13 November 2025, cols 339–42
• Oral question on ‘Public services: Online communications’, HL Hansard, 2 December 2025, cols 1684–7
• Debate on ‘Adult cerebral palsy: National service specification’, HC Hansard, 10 March 2026, cols 45–52WH
• Debate on ‘Clive Treacey safety checklist’, HC Hansard, 17 November 2025, cols 581–6
• House of Lords Committee on the Autism Act 2009, ‘Time to deliver: The Autism Act 2009 and the new autism strategy’, HL Paper 205 of session 2024–26, 23 November 2025; and ‘Government response’, 23 January 2026

Briefings

• House of Lords Library, ‘Challenges faced by people with disabilities’, 13 May 2024
• House of Commons Library, ‘The national disability strategy: Content, reaction and progress’, 15 July 2025

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