Developing the role of the Learning Disability Physician

Abstract

Introduction: People with learning disabilities (LD) comprise up to 2% of the population(1). They are a heterogenous group of people who have high rates of physical morbidity with up to 11 long-term conditions(2). The health outcomes for people with LD are poor with life expectancy 20 years lower than the general population(3). They have high rates of medication use(4). Health services are challenged in meeting their needs that has resulted in avoidable deaths(5). Families and clinicians have advocated for the development of the role of LD physician dedicated to supporting people with LD in secondary and primary care(6, 7, 8). UK Parliamentary consultations have raised interest in the role(9). The model of LD Physician in the Netherlands has inspired the introduction of the role in the NHS with the development of a training programme by the Royal College of Physicians (London)(10). Method: The training of doctors in the medical needs of people with LD is essential to develop and expand the role. A training programme has been developed by Royal College of Physicians (London) delivered by Edge Hill University with the support of NHS England (Workforce). The aim of the training programme is to enhance the knowledge and skills of doctors on the medical needs of adults with LD. Results and discussion: The training programme was created through advocacy by clinicians with first-hand experience of supporting people with LD. With the support of NHS England (Workforce), RCP London has developed the training programme in partnership with Edge Hill University. A two-module training course is delivered remotely over 12 months. The training adopts a multi-disciplinary approach and is coproduced with adults with learning disability. NHSE has funded 40 places for 3 years. 40 clinicians have completed the course gaining knowledge in assessing and treating disease in people with LD. An awareness of multimorbidity is key to treating people successfully. The training is intended to enhance the clinician's skills such as communication with people with LD and recognising multimorbidity. The requirement of learners is to have direct patient contact with people with LD. Assessment includes the learner reflecting on clinical cases combined with their learning from current evidence. Feedback from learners has been positive about the quality of the content of the course, and the overall learning they gained from it. Conclusion: The training course is an innovation by the RCP London with Edge Hill University on meeting the specific needs of adults with learning disabilities. The programme is in line with Government policy delivered by NHSE in the Learning Disability and Autism Programme of the NHS Long-term Plan. The Programme aims to reduce morbidity and mortality among people with learning disabilities in England by equiping with the skills to meet the medical needs of adults with learning disabilities. Greater promotion of the training course will be required to effectively achieve the aims of the NHSE Programme.