Annual health checks

People with a learning disability often have poorer physical and mental health than other people.  An annual health check can improve people’s health by spotting problems earlier.

Watch this film to find out how a great annual health check and health action plan is helping Charlotte to keep healthy and stay well.

Annual health checks during coronavirus

In order to reduce the risk of increased unnecessary deaths in people with a learning disability during the coronavirus outbreak it is essential that annual health checks continue to be carried out.

This easy read letter, which has been developed with people with lived experience, can be adapted to help explain to people with a learning disability and their family and carers that the way health checks are carried out may have changed.

Learning disability services in Hertfordshire have produced this useful pathway to completing annual heath checks during the coronavirus pandemic.

What happens at an annual health check?

People with a learning disability can sometimes find it hard to know when they are unwell, or to tell someone about it.  A health check once a year gives people time to talk about anything that is worrying them and means they can get used to going to visit the doctor.

To find out more you can watch an annual health check video from the NHS website.

Who can have an annual health check?

Anyone over the age of 14 with a learning disability, can have an annual health check. Children would usually see a different doctor until they are 14 years old.

How do I get an annual health check?

To have an annual health check your doctor needs to know you have learning disability.  Watch this video which we have made with Mencap to tell you how to make sure you don’t miss out on your health check.

Annual health check exemplars

In 2020/2021, we asked NHS organisations across the country to put themselves forward to become learning disability exemplars. The role of the exemplars will be to look at how care can be made better so that people with a learning disability can live healthier and happier lives.

The organisations sought to increase annual health checks by:

  • Bringing together the NHS, local authorities and self-advocacy groups or experts by experience to look at some of the complex issues which we know affect the health of people with a learning disability
  • Work with partner organisations to understand more about how services could be changed to help people with a learning disability to live healthier and happier lives
  • Look at ways of making sure people with a learning disability are on a GP learning disability register so that they get the care and treatment they need at the right time
  • Sharing what they have learnt and what is working well with other health and social care organisations.

Nine CCG areas, which are now part of Integrated Commissioning Board areas, were appointed as exemplars and they looked at how to increase annual health checks in their area.

Annual health checks in secondary care

The NHS Long Term Plan set an ambition that by 2023/24, at least 75% of people aged 14 or over with a learning disability will have had an annual health check. Performance in 2020-21 has been impacted by multiple factors, particularly COVID-19 and it is important to consider other novel ways of improving both uptake and quality.

In June 2021, we called for local community and specialist learning disability service providers and other teams across the country to develop local pilots. The pilots were to showcase the opportunity for new and creative ways of working at a system-wide or clinical commissioning group level. They were able to demonstrate the specific contribution that community or specialist providers can make in supporting local annual health check arrangements which would lead to increased uptake and support improved quality of annual health checks for people with a learning disability.

The ambition was for the pilot sites to work in collaboration with their local stakeholders to deliver health improvements via the annual health check process. Delivery of annual health checks are the responsibility of individual GP practices in primary care and this project aims to build on, and not to detract or undermine, these principles.

Slides from the introductory webinar held on 29 June 2021 are available.

Seven pilot sites (shown below), one in each region, were selected from a number of wider ranging and innovative bids focused on delivering uptake and quality of annual health checks utilising wider partnership working and expertise. There were 36 bids submitted in total across all regions. The intention was that successful pilot sites would operate from the 1st of October 2021 to 30th of September 2022. In some cases, given organisational changes caused by Covid19, this period of operation has been extended into 2023.

Annual health check in secondary care pilot sites 2021/2022

NHS Suffolk and North East Essex Integrated Care Board on behalf of Norfolk and Suffolk Foundation Trust

  • Employ a specific band 3/4 in the Primary Liaison team.
  • Clear engagement with self-advocates and a focus on children and young people.
  • Clear partnership working between primary and specialist care.
  • Focus on understanding barriers to engagement as well as driving uptake and quality.
  • Good link into the wider health improvement agenda such as the use of specific software to enable better risk stratification and promote opportunistic intervention, for example, screening.

NHS Gloucestershire Integrated Commissioning Board on behalf of One Gloucestershire and Partners

  • Using technology to develop a digital dashboard related to annual health checks.
  • Clear collaboration with multiple agencies to drive both uptake and quality of checks with clear workstreams and supporting data.
  • Focus on wider education and training for professionals based on service user feedback.
  • Plan to co-develop a more interactive and accessible health action plan.
  • Funding split between workstreams to support clear delivery of project aims.

NHS South West London Integrated Commissioning Board on behalf of Sutton Health and Care Provider Alliance and Partners

  • Employ a band 7 learning disability nurse (x0.4) to act as annual health check facilitator undertaking outreach for non-attenders.
  • Clear focus on personalised care and enhanced quality of health action plans.
  • Plans for outreach into local Black Asian and minority ethnic communities using specialist expertise.
  • Inclusion of children and young people within the work, with development of a specific annual health check pathway for younger people.
  • Building on exemplar work to extend the reach and with plans for longer term sustainability for the role.

NHS Kent and Medway Integrated Commissioning Board on behalf of Kent Council and Partners

  • Funding to be used to deliver peer led training, family groups and peer supporters to deliver education and drive uptake of annual health checks for young people.
  • Exploring neurodiversity linking into current annual health check steering group.
  • Exploring areas of higher deprivation and reaching out to children and young people to explore barriers and to understand the potential to improve quality.
  • Excellent co-production identified with children and young people to grow awareness and understanding, and therefore engagement.
  • Plans to link Health action plan with EHCP.

NHS Nottingham and Nottinghamshire Integrated Commissioning Board on behalf of Nottinghamshire Healthcare NHS Foundation Trust. and Partners

  • Employ a specific nursing role in the Primary Care liaison team.
  • Clear engagement with local Black Asian and minority ethnic communities, with clear data to support the need and wider scope.
  • Planned outreach work for uptake in community for those that do not attend providing opportunistic annual health checks in novel settings.
  • Focus on educating people to engage with primary care for subsequent annual health check and opportunistic checks to support health improvement agenda.
  • Clear partnership working and a fully co-produced bid.

NHS Humber and North Yorkshire Integrated Commissioning Board Group on behalf of Bridlington Primary Care Network and Partners

  • Building on current outreach work via a dedicated health and wellbeing hub.
  • Further develop the hub offering and environment to incorporate improved reasonable adjustments.
  • Take the annual health check process, supported by GP and learning disability nurses, to the hub setting.
  • Multi-professional service to drive uptake and quality including use of social prescribers and peer support workers.
  • Good co-production with a degree of long-term sustainability and quality improvement agenda.

NHS Cheshire and Merseyside Integrated Commissioning Board on behalf of Cheshire and Wirral Partnership NHS Foundation Trust and Partners.

  • Employ specific roles including a peer support worker, and community learning disability nurses.
  • Peer worker to undertake outreach, education and quality assessment work.
  • Reaching out to Black and Asian and minority ethnic communities as well as children and young people.
  • Partnership working with a specialist nurse as well as developing a child specific health check pathway.
  • Building on strong local networks and proven delivery.

Information for health and social care staff

We are working with partners to get more people on their GPs learning disability register.

This will mean that more people will have a health check and get the care that they need.

To make sure this happens there has been an increase in the payment available for GPs providing annual health checks the introduction of a national health check template.

National health check template

The template has been produced on three of the main GP clinical systems. It is available on EMISWeb and on Vision now and the template for TPP System One is in its final stages and will be available soon.

If you use different GP system software please visit the NHS Employers resources to view the national template in Word version and with EMIS screenshots www.england.nhs.uk/gp/gpfv/investment/gp-contract/

Emis users

The template is in EMIS Library > Primary Care Templates > Learning Disabilities HCAP

The template is active, the protocol is inactive.

The protocol – To activate the protocol, you need to go into the templates manager and then navigate to EMIS Library > EMIS Protocols > DES Protocols Its in as Health Check Action Plan Launch and Print Protocol. Right click on it, select Status and click activate, it will then be available to add to your F12 menu 

Vision users

For Vision users instructions for downloading templates are found on the Vision website.

Royal College of General Practitioners – toolkit for doctors

The health checks for people with learning disabilities toolkit is aimed at helping GPs and practice nurses carry out the health check to a high standard and make sure that people with a learning disability get timely access to the healthcare they need in the right place, at the right time.

Better health for people with a learning disability: what social care staff need to know about GP learning disability registers, Annual Health Checks and the Summary Care Record – this guidance document and accompanying film was developed by NDTi and VODG and is designed to support social care providers who want to improve the health and therefore the lives of the people they support.

Summary care record

Another way to help patients with a learning disability is by asking for their consent to add additional information to their summary care record.