Annual Health Checks (AHCs)

The annual health check is a yearly touchpoint where we have the opportunity to meet our patients and supporters when well, to listen to their current concerns, and perform a systematic review of the common co-occurring conditions which may cause serious symptoms, arrange to manage them, and refer on where necessary. A health action plan is delivered to help system partners and supporters to look after the patient in the year until the next check, including prompting optician checks, vaccinations, and documenting goals and referrals.

NHS: annual health checks learning disabilities

Keeping a register or list of people with a learning disability enables them to be invited for annual health checks and regular vaccinations.

NHS England: find out more about the Learning Disability Register – leaflet

Learning Disability Service Leeds: learning disability register inclusion tool

Learning Disability Matters: screening tool for learning disabilities

Mencap: how to join the learning disability register

All patients with a learning disability  are eligible for an annual health check. These start at age 14 in England and Northern Ireland, 16 in Scotland, 18 in Wales. Templates to support the AHC are on GP systems.

NHS Inform - Annual health check for people with a learning disability (Scotland)

NHS Wales. Annual health check

Education Authority Northern Ireland. Annual health checks

Learning Disability Network: learning disability diamond standards in primary care

National Devolpmental Team for Inclusion (NDTI): annual health check resources & guides

RCGP: step-by-step guide to health checks for people with a learning disability

Patients may need support preparing for an AHC and it may be helpful if they are accompanied by someone who knows them well.

Youtube video by the NHS England Social Team: 'Charlotte's annual health check and health action plan'

NHS England: annual health checks

Learning Disability Service Leeds: annual health check information for families and carers

Learning Disability Service Leeds: resources for annual health checks

NHS Sussex: learning disability annual health check toolkit

AHCs need to be accessible; consider how invitations are sent and how you follow up when people are not brought or do not attend. 

NHS England: annual health check videos

NHS: annual health checks learning disabilities

Mencap: annual health checks (Easy Read)

Mencap: GP resources for Black, Asian and Minority Ethnic people with a learning disability

Autism Independence: patient leaflet on annual health checks

Autism Independence: the importance of annual health checks for people with a learning disability

Changing Our Lives: 'Chai, Mithai and Challenging Myths: The Facts About Disability' Youtube video

People with Down Syndrome are more likely to have certain conditions such as congenital cardiac disease and specific guidance exists.

Down’s Syndrome North East

Down Syndrome Medical Interest Group: guidance for medical surveillance

A Health Action Plan (HAP) should be produced at the end of the AHC to identify a patient’s health needs, including what the patient needs to do to get/stay well, who will help and when this will be reviewed.

Derbyshire Healthcare NHS: health action plan

Autism Independence have produced posters in various languages to be used in GP practices' waiting areas. The posters detail support that they provide for people with a learning disability to access their annual health check.

Autism Independence: annual healthcheck poster in English

Autism Independence: annual healthcheck poster in Arabic

Autism Independence: annual healthcheck poster in Polish

Autism Independence: annual healthcheck poster in Somali

Autism Independence: annual healthcheck poster in Urdu

Prescribing is the most common intervention in primary care. People with a learning disability are often prescribed multiple medicines because of co-occurring conditions and to treate behaviours which are described as challenging. Antipsychotics, antiepileptics and benzodiazepines are the most commonly prescribed medications, even when there is no underlying diagnosis of a mental health condition or epilepsy. Adverse outcomes from use of antipsychotic medications include movement disorders, metabolic complications and increased mortality. More detail on this is given later in this toolkit. 

NHS England: stopping over medication of people with a learning disability and autistic people (STOMP) and supporting treatment and appropriate medication in paediatrics (STAMP)

NICE Guidance NG11: challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges

NHS Lancashire & South Cumbria: medications and my mental health. A research study about mental health medications in the lives of people with learning disabilities

Central and North West London NHS Foundation Trust: easy read medication leaflets

University of Birmingham: medicine information - learning disabilities medication guideline