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Health checks in primary care for adults with intellectual disabilities: how extensive should they be?
- Authors:
- CHAUHAN U., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 54(6), June 2010, pp.479-486.
- Publisher:
- Wiley
General practitioners in the UK are being incentivised to carry out health checks under the Quality and Outcomes Framework (QOF) as a way of detecting unmet need for adults with intellectual disabilities (ID). This study looked at the key parameters recorded as part of the health check and compared any additional value with standard care provided through the current QOF framework. Twenty seven representative practices from four English primary care trusts (Haringey, Nottinghamshire, Oldham and Warwickshire) carried out health checks over a 6-month period. The data were divided into two domains for analysis: 'ID-specific' (visual assessment, hearing assessment, behaviour assessment, bladder function, bowel function and feeding assessment) and the financially incentivised QOF targets (blood pressure, smoking status, ethnicity, body mass index, urine analysis and carer details). A total of 651 ID patients were identified; only nine practices undertook a health check on 92 of their patients with ID during the pilot. Significant differences were found in the recorded information, between those who underwent a health check and those who did not. For those that had a health check, recorded information was on average higher for the 'QOF targets' compared with the 'ID-specific' domain, by 58.7%. The authors suggest that a more targeted approach focused in incentivising ID-specific health issues might be more appropriate than an extensive health check for improving care for people with ID.
Mind the healthcare gap
- Author:
- NADIRSHAW Zenobia
- Journal article citation:
- Learning Disability Today, 9(5), July 2009, pp.30-31.
- Publisher:
- Pavilion
- Place of publication:
- Hove
The health inequalities faced by people with learning disabilities and the possible reasons for these inequalities are discussed. The need for proper health needs assessments and the need to include health assessment in person-centred plans is highlighted.
What do Joint Strategic Needs Assessments tell us about people with learning disabilities in England?
- Authors:
- BAINES Susannah, HATTON Chris
- Journal article citation:
- Tizard Learning Disability Review, 20(2), 2015, pp.92-96.
- Publisher:
- Emerald
Purpose: A 2013 analysis of local authority Joint Strategic Needs Assessments (JSNAs) showed that JSNAs were not routinely including information on the numbers and health needs of people with learning disabilities, particularly children. This paper compares the information included in 2013 and 2014 JSNAs. Design/methodology/approach: JSNAs for 141 local authorities in England were sought. Local authorities were contacted when JSNAs were not initially found online. All 137 JSNAs found were analysed for mentions and specific sections concerning people with learning disabilities, and content analysed concerning the specific information they contained. Findings: In total, 72 per cent of JSNAs mentioned people with learning disabilities (vs 82 per cent in 2013); 24 per cent mentioned children (vs 39 per cent in 2013) and 72 per cent mentioned adults (vs 81 per cent in 2013). Overall, 13 per cent of JSNAs included a section on children with learning disabilities (vs 9 per cent in 2013), 65 per cent included a section on adults (vs 48 per cent in 2013) and 11 per cent included a section on older adults (vs 8 per cent in the 2013). More JSNAs contained information on current and projected future populations, health needs, social context and service usage concerning adults with learning disabilities compared to children. There was large regional variation in all these indicators. Originality/value: Further work is needed for JSNAs to contain sufficient information on people with learning disabilities to allow for strategic planning, and for JSNAs to be accessible to the public. (Edited publisher abstract)
Caring for the physical and mental health of people with learning disabilities
- Authors:
- PERRY David, et al
- Publisher:
- Jessica Kingsley
- Publication year:
- 2010
- Pagination:
- 176p.
- Place of publication:
- London
The authors suggest that although people with learning disabilities are at greater risk of physical and psychiatric illness than the majority of the population their health needs are not always adequately supported. This book is a practical guide for those caring for people with learning disabilities who live in community settings. It aims to help carers better understand what the service users' health needs may be, how to recognise problems, and how to meet these needs. Subjects discussed include: physical health issues such as epilepsy, common health problems and diet and well-being; mental health issues such as dementia, depression, bipolar disorder and anxiety; and information related to common difficulties such as sleep and swallowing problems. The final section of the book focuses on accessing services, screening programmes, health checks, and when admission to psychiatric care is required. An appendix looks at genetic causes of learning disability and a glossary and references are provided.
Methodological issues in inclusive intellectual disability research: a health promotion needs assessment of people attending Irish disability services
- Authors:
- BOLAND M., DALY L., STAINES A.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(3), May 2008, pp.199-209.
- Publisher:
- Wiley
This paper describes a combination of inclusive methods to evaluate health and health promotion needs of service users with intellectual disability. Sixty centres provide disability services to over 900 clients with intellectual disability in the East Coast Area Health Board region of Ireland (population approximately 325 000). The research included interviewer-directed surveys of 247 clients with intellectual disability (or advocates) and 180 clients with physical/sensory disability; focus groups for clients, service providers and carers; and a postal survey for centre managers. Modification of existing surveys was required for people with intellectual disability. Fifty-six of 60 (93.3%) centres participated. The response rate at the client level was 98.8% (3/250 refusals). Health behaviours, likes and dislikes were well described by clients and advocates. Clients identified the need for more creative therapy, physical activity, relaxation therapy and social activities. Service providers and carers emphasized more the need for speech and language therapy, counselling, occupational therapy and physiotherapy. Concludes that inclusive research methods can produce useful outcome measures of the health promotion needs of those with disability. Triangulation is valuable, where clients, carers and service providers are all involved in the research process.
The extension of a set of needs-led mental health clusters to accommodate people accessing UK intellectual disability health services
- Authors:
- PAINTER Jon, et al
- Journal article citation:
- Journal of Mental Health, 27(2), 2018, pp.103-111.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: A development of a needs-led mental health classification system based on the Health of the National Outcome Scales (HoNOS) has previously been developed. Aims: To extend the needs-based mental health (MH) clusters to accommodate the additional needs of people accessing UK intellectual disabilities health services. Method: Hierarchical cluster analysis was performed on assessment data from 18 National Health Service (NHS) provider organisations. The statistical results were clinically shaped through multi-disciplinary workshops. The resulting clusters were combined with six independently rated measures for a second data collection exercise. Based on these data, refinements were made before performing internal and external validity checks.Results: Eight additional clusters for people with health needs associated with their intellectual disabilities were produced. Three described primarily physical health (PH) needs, four described needs arising from behaviours which challenged (with/without autism) whilst one described people with generally low needs. Together, these covered 83.4% of cases with only a 10% overlap. The clusters were replicable and had clinical utility and validity. Conclusions: It was possible to extend the needs-led mental health classification system to capture the additional needs of people accessing UK intellectual disability services. (Edited publisher abstract)
Applying a general measure of frailty to assess the aging related needs of adults with intellectual and developmental disabilities
- Authors:
- McKENZIE Katherine, OUELLETTE-KUNTZ Helene, MARTIN Lynn
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 14(2), 2017, pp.124-128.
- Publisher:
- Wiley
Adults with intellectual and developmental disabilities often experience premature ageing and high levels of frailty. Frailty characterises health complexities and identifies adults with increased risks for adverse outcomes. This paper compared the prevalence of frailty amongst adults (aged 18-99 years) with and without intellectual and developmental disabilities. Frailty was measured using the Frailty Marker, based on the Adjusted Clinical Groups-Predicative Model, and was compared between a cohort of 51,138 adults with intellectual and developmental disabilities and a random sample of 3,272,080 adults without intellectual developmental disabilities. Approximately 9% of persons with intellectual and developmental disabilities were frail, compared to only 3% of persons without intellectual and developmental disabilities. Women, older adults, and adults with mental illness or addiction(s), were more likely to be frail. Adults with intellectual and developmental disabilities are increasingly vulnerable as they age. However, to appropriately characterise frailty in this population, measures should be more inclusive of health characteristics and fluctuations that are related to frailty. Future research should investigate alternative measures of frailty for persons with intellectual and developmental disabilities, including measures derived from standardised health assessments, to meet the needs of the ageing population. (Edited publisher abstract)
Education, health and care plans: examples of good practice
- Author:
- COUNCIL FOR DISABLED CHILDREN
- Publisher:
- Council for Disabled Children
- Publication year:
- 2016
- Pagination:
- 44
- Place of publication:
- London
A resource to help practitioners to write good quality Education Health and Care (EHC) plans that meet both the letter and the spirit of the Children and Families Act 2014. It aims to help those contributing to EHC needs assessments and those writing EHC plans. Section A includes excerpts from real EHC plans and tips for completing an EHC plan. Section B provides EHC plans for two fictional children, which draw on real examples. Each section covers different areas of EHC plans, including the aspirations of the child; the child or young persons’ special educational needs; health needs; social care needs; the outcomes sought for the child or the young person; and special educational, health and social care provision. The resource aims to encourage discussion about the key features of high quality EHC plans. (Edited publisher abstract)
Learning disability: care and support of people growing older: (QS187)
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2019
- Pagination:
- 30
- Place of publication:
- London
Quality standard covering identifying, assessing and regularly reviewing the care and support needs of people with a learning disability as they grow older. It focuses on the specific health and social care needs associated with an individual's learning disability. It contains five quality statements which describe what high-quality care looks the areas of: person-centred needs assessment, named lead practitioners, future planning and review, annual health checks and hospital admission. The standard provides information on the rationale for each quality statement, quality measures that can be used to monitor improvement and what the statement should mean for different audiences, including service providers, commissioners and people growing older with a learning disability. (Edited publisher abstract)
Gap analysis of service needs for adults with neurodevelopmental disorders
- Author:
- BURKE Shanna L.
- Journal article citation:
- Journal of Intellectual Disabilities, 23(1), 2019, pp.97-116.
- Publisher:
- Sage
- Place of publication:
- London
In Florida, the Agency for Persons with Disabilities provides waivers for adults with the following types of disabilities: intellectual disability, autism spectrum disorder, cerebral palsy, spina bifida, Down syndrome, and Prader–Willi syndrome. This review examined the peer-reviewed literature to indicate and assess the common needs for individuals with intellectual and developmental disabilities. Current models of service delivery, the efficacy of these services, and remaining gaps in the need fulfilment of individuals within the six diagnostic categorizations of interest were examined. Severity level within each diagnostic category was plotted on a matrix according to whether the needs of individuals were minimal, moderate, severe, or universal. The study found that sexual health education, socialization, and adult-focused medical care are universal needs among the six conditions. The study indicates that health-care professionals must work toward addressing the many unmet needs in comprehensive life span care services for adult individuals with neurodevelopmental disorders. (Edited publisher abstract)