Management of long-term conditions in primary health care for adults with learning disabilities compared with the general population


Background                                   

The UK general practitioners contract included a pay for performance element for management of long-term conditions, according to best-practice indicators, defined by the Quality and Outcomes Framework (QOF). This study uses QOF to measures good practice for adults with learning disabilities compared with the general population at two time points.

What we did

Patient records of adults with learning disabilities registered with participating general practices were extracted and analysed in 2010 (n=721) and in 2014 (n=4,066) to determine management of long-term conditions according to QOF indicators. Comparisons at both times were made with the general population from the same health board.  Additionally, prevalence of long term conditions was determined, and associations with age, gender, ability, type of accommodation, and neighbourhood deprivation were investigated via logistic regression analyses.

What we found

Adults with learning disabilities received poorer management of long–term conditions compared to the general population on 53/57 (92.9%) indicators in 2010, and 38/54 (70.4%) indicators in 2014. Improvements were found at 2014 as achievement was high (76-100%) for 19.6% of adults with learning disabilities in 2010, compared to 74.1% in 2014. Adults with learning disabilities had higher rates of epilepsy, psychosis, hypothyroidism, asthma, diabetes, and heart failure; with little association with ability, accommodation-type or neighbourhood deprivation.

What these findings mean

High quality management of long term conditions is essential to maintain and improve health. The healthcare inequality gap between people with learning disabilities and the general population narrowed between 2010 and 2014, though people with learning disabilities still experienced poorer management of their long term conditions.

For more information about this research, contact Laura Hughes-McCormack

Page updated 1 May 2018