How can we make annual health checks (AHCs) for adults with learning disabilities more effective?

At ARU’s School of Medicine Annual Conference last month, I co-presented on a literature review which I completed in 2025 with an ARU medical student, focused on the impact of AHCs on health outcomes for adults with learning disabilities. As a parent of a young adult with severe learning disabilities, this review was more than just an academic piece of work: it was also a labour of love.

Knowledge is power

Based on my lived experience, the review’s central finding that attending an AHC alone is insufficient to improve health outcomes came as no surprise to me. I was similarly unsurprised by its evidence that many primary care practice staff, people with learning disabilities and their carers lack sufficient confidence or knowledge to ensure that this consultation is effective in improving health.

I have attended numerous AHCs with my daughter, yet it wasn’t until I undertook this academic work that I discovered the full intention of the check, what it was supposed to consist of, and that she should have been offered a Health Action Plan (HAP) detailing the consultation’s outcomes and next steps.

A frustrating experience

Even once armed with this information, the quality of her next AHC consultation was incredibly poor, starting from the appointment-making process, with the receptionist asking us to attend the next day unaware that routine blood tests should be carried out beforehand, through the 10-minute consultation itself with the unfamiliar nurse prescriber who barely spoke, and simply left out certain checks on height and weight. The nurse prescriber did, however, refer my daughter to the Learning Disability Service for support with the health concerns I flagged, and printed out a HAP at my request.

Following my daughter’s hour-long appointment with a nurse from the Learning Disability Service in which all her routine checks were completed, I was unimpressed to be re-referred to the same practice nurse prescriber for a prescription for medication about a health concern that I had expressed in the AHC. It meant another appointment when the prescription could have been issued during the initial AHC.

Nothing about us without us

To be fair, this was a particularly poor experience which chimes with the review findings that highlighted the variation in quality of patients’ experiences. Looking back at previous AHCs, some were better when they were carried out with a familiar GP who took the time to carry out a thorough consultation, which resulted in our greater satisfaction with the outcomes, although no HAP was provided and I did not know to ask for one.

So, the call in our literature review for improvements to AHCs is a heartfelt one. Greater knowledge of learning disability and how to carry out AHCs in primary care is needed. Practice staff, people with learning disabilities and their carers all need to be empowered to fully participate in the consultation and ensure positive experiences.

Existing good practice examples show that co-production works and needs to be extended into supporting healthcare infrastructures, throughout information, research and medical training to become standard practice. Only then, once people with learning disabilities and their carers are treated as equal partners in their own care throughout our healthcare system, will their health outcomes improve.

Catherine Kennelly, Research Assistant, Faculty of Health, Medicine and Social Care