As a GP, what is the one thing we want
most for our patients? For me it has
always been to offer high quality of
care to all of my patients and to make
sure that no one is excluded or left
behind and the voice the patient is heard.
They do do quite well the doctors
that I'm under now but not every doctor
I would give flying colours to that I've seen.
I think all doctors, you know, sometimes rush.
I just like seeing the same
doctor but sometimes I can't
so I have to see someone else.
I'm quite  independent. I go on my own but my
husband on the other hand has got very
high needs. He had to change surgeries
because it wasn't disabled access.
But did you know that people with learning
disabilities have a significantly lower
life expectancy than people in the
general population? Shockingly this is 22
years less in the case of men and 29
years for women. And people with a
profound or multiple learning
disabilities have a mean age at death of
41 years. And this is not solely due to
complex co-morbidities but frequently
relates to preventable and treatable
conditions. These figures certainly made
me stop in my tracks and wonder what we
as GPs are doing to improve these
statistics? So when I was appointed the
role of London Clinical Champion for the
Learning Disability Mortality Review Programme or
colloquially known as the LeDeR programme, 
this was something I felt I could make a
positive contribution towards. So what is
the LeDeR programme? It is a national
initiative which has been commissioned
by NHS England to support local areas in
England to review the deaths of all
people with a learning disability who
were aged four years and older at the
time of their death. After a death a
reviewer is appointed and they work to
identify learning points so that action
plans can be developed locally to
improve care. It's important for you to
understand this is a review to support
quality improvement it is not an
investigation. So where do us as GPs need
to contribute and participate?
Firstly we need to notify the death of
any of our patients with a learning
disability to the LeDeR programme. You can do this by speaking directly to a member
of the LeDeR team or by using the
secure web-based portal on the leader
website. And secondly we need to engage with 
the LeDeR reviewers and help them
understand the circumstances leading up to the death of the deceased person.
So what else as GPs can we do? We should
encourage our patients to attend for
their annual flu jabs, we should
encourage them to engage with cancer
screening programmes but of course
probably the most useful thing we can do
is to ensure that it is easy for them to
attend their annual health checks.
The annual health check is an opportunity to
take a holistic view of our patients,
bring all the information together and
develop a health action plan to try and
ensure the patient receives proactive
good preventative care.
I recommend the excellent resource
developed by the Royal College of
General Practitioners where there's a
step-by-step guide on how to approach
this health check. This is a short video
but in conclusion there's much that we
GPs and our practices can do to improve
the standard of care for our patients
with learning disabilities and
ultimately reduce the health
inequalities experienced. This work is
important and we should not
underestimate the positive contribution
we can make to our patients their
families and carers.
