As a minimum, the health check should include a collaborative review with the patient and carer (where applicable) of physical and mental health including:
- A full physical examination
- Chronic illness and systems enquiry
- Health promotion
- Check and prompt of participation in age-related screening programmes
- Behaviour and mental health
- Syndrome-specific checks
- A check on the accuracy and appropriateness of prescribed medications
- A review of whether vaccinations and immunisations are up to date, for instance seasonal influenza
- A review of coordination arrangements with secondary care, recording likely reasonable adjustments should secondary care be needed e.g. longer appointments required, need for easy read information or carer accommodation etc
- A review of transition arrangements where appropriate for younger people, and those changing accommodation or care provider
- A review of communication needs, particularly how the person might communicate pain or distress
- Support for the patient to manage their own health and make decisions about their health and healthcare, including through providing information in a format they can understand and any support they may need to communicate
- A review of family carer needs should also be included
Any forthcoming screening invitations should be discussed with the patient and easy-read information provided if required. Some useful screening guides are available to view below:
- Bowel Cancer Screening Guide
- The Bowel Screening Test Leaflet
- Breast Screening Guide
- Cervical Cancer Leaflet
- Cervical Screening Guide
- Abdominal Aortic Aneurysm Screening Guide
Stopping over-medication of people with a learning disability
There is a national drive to Stop the Over-Medication of People with Learning Disabilities (STOMP) and Supporting Treatment and Appropriate Medication in Paediatrics (STAMP).
The Annual Health check is an opportunity for GPs to review medication, particularly psychotropic medication, to ensure that the medication prescribed is still appropriate and effective.
The following organisations have a range of easy-read leaflets and tools on topics such as the brain, stress, mental health, epilepsy, depression, dementia, behaviour problems, anxiety, alcohol and abuse:
What can help?
Where problems or concerns are identified, practices will be expected to address them as appropriate through the usual practice routes or via specialist referral if required. More information can be found in The Royal College of General Practitioners – Good Practice Guidance.
Other areas where an Annual Health Check can help
Practices may find that the annual learning disability health check also provides an ideal opportunity to check for other concerns, such as:
- Facilitating timely diagnosis and post-diagnostic support for people with dementia
- Avoiding unplanned admissions: proactive case finding and care review for vulnerable people
- Personalised advanced care planning
Some patients may have difficulty with blood tests. The Public Health England guide ‘blood tests for people with learning disabilities‘ may help.