Plans to ramp up NHS care in neighbourhood health centres have come under fire for ‘barely mentioning’ people with learning disabilities
Plans to ramp up NHS care in neighbourhood health centres have come under fire for “barely mentioning” people with learning disabilities.
Leading charity Mencap, which represents those with a learning disability, branded it a “national scandal” that people in this group die on average 20 years earlier than the general population.
Chief executive of the charity Jon Sparkes said the Government’s new Neighbourhood Health Framework – which offers more joined-up services closer to home – is “on paper” everything people with learning disabilities have been asking for.
But he continued: “Yet these people, who stand to benefit most from this new approach, are missing from the list of priority groups. The very people who face some of the starkest health inequalities in the country are barely mentioned in the framework that’s supposed to tackle the huge health inequalities they face.”
READ MORE: Dozens of new neighbourhood health centres unveiled – see full list of areas
Mr Sparkes said he feared services would not be designed with the group in mind amid government assurances they will be included years down the line. “The risk now is that support for people with a learning disability is quietly kicked into the long grass,” he added.
The Government’s neighbourhood health framework, published in March, references people with learning disabilities once, where it says it hopes to support them with services “over the next few years”. It insists “important reform agendas” in this area will continue.
It says: “Over the next few years, we will look at how we can support other important services to effectively contribute to neighbourhoods, such as community pharmacy, dental services, optometry, learning disabilities and neurodiversity services and others. In the meantime, important reform agendas will continue to improve services in these areas.”
People with learning disabilities are dying almost 20 years younger than the rest of the population in England, a report commissioned by the NHS found in September. Mencap said there are currently around 900,000 working-age adults with a learning disability in the UK, but less people in work than from any other disability group.
The Government’s neighbourhood health centres include GP services, pharmacies, physiotherapy, blood tests and mental health support. They will also offer wider services like debt advice and employment and family support. The first 27 centres will be open to patients next year.
‘There is a real chance to shape an NHS that works for everyone’
By Jon Sparkes OBE, chief executive of learning disability charity Mencap:
The Government’s new Neighbourhood Health Framework promises a revolution in how we access care. Services will be organised around the person, not the postcode.
Support will be more joined up, more personal, and delivered closer to home. On paper, it’s everything people with a learning disability have been asking for: accessible appointments, continuity of care, fewer barriers, and a system that adapts to the individual rather than expecting them to navigate a maze.
Yet these people, who stand to benefit most from this new approach, are missing from the list of priority groups. The very people who face some of the starkest health inequalities in the country are barely mentioned in the framework that’s supposed to tackle the huge health inequalities they face.
People with a learning disability die, on average, around twenty years earlier than the general population and are twice as likely to die from avoidable causes. This is not a niche issue or a marginal concern, it’s a national scandal. Many have complex long-term conditions, higher mental health needs, or are unable to leave their homes without support. Yet they face huge barriers to accessing even the most basic healthcare: digital systems they cannot navigate, telephone triage that doesn’t work for them, inaccessible letters, rushed appointments, and long waits for the reasonable adjustments they’re legally entitled to.
The new neighbourhood framework, as it stands, offers little in how any of this will be fixed.
To be fair, ministers have said all the right things so far. The ambition to deliver more personalised care is genuinely welcome. NHS England has been clear that more detail will follow, and some of the early commitments, from eradicating inappropriate Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions to improving continuity of care, are positive steps in the right direction.
But in last year’s 10‑Year Health Plan the neighbourhood framework was clearly billed as the key vehicle for tackling health inequalities among people with a learning disability. Leaving them out now cannot be dismissed as a technicality or something to “pick up later”. If services are not designed from the outset with people with a learning disability in mind, they simply will not work for them. We’ve seen this too many times: digital first systems that lock people out; well-meaning reforms that rely on processes people can’t access; responsibilities pushed down to local systems without clear national expectations.
The risk now is that support for people with a learning disability is quietly kicked into the long grass, devolved to local Integrated Care Boards years down the line, with no guarantee of consistent action or accountability.
There is a real chance, right now, to shape an NHS that works for everyone. That means openly recognising people with a learning disability as a priority within the neighbourhood approach and making it clear that local services must build in accessibility and reasonable adjustments from the very start.
Let’s finally put an end to the pattern of leaving behind those who face the toughest barriers to good health.