A learning disability affects the way a person learns new things, understands information and how they communicate. Valuing People defined learning disability as:

• a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with;
• a reduced ability to cope independently (impaired social functioning) which started before adulthood with a lasting effect on development

People with learning disabilities are among the most vulnerable in our society, generally having greater and more complex health needs than the general population, and often these needs are not identified or treated. Research shows life expectancy of people with learning disabilities is increasing, but is lower than the general population.

This chapter provides an insight into the prevalence of adults with learning disabilities living in Nottinghamshire. Using a variety of data sources it explores several interconnected areas including primary care health needs, accommodation status, assessed level of learning disability, mortality, employment and learning disability health checks. This chapter also gives an overview of current service provision and assets.

Diagnosis and prevalence

It is broadly estimated that approximately 2% of the adult population will have a learning disability, however a significant proportion of this group will not be known to health or social care services. Evidence shows estimates vary because many adults with mild learning disabilities do not use specialist learning disability services, and are unlikely to self-identify as having a learning disability.

Using POPPI and PANSI estimates, it is predicted the number of adults in Nottinghamshire with a learning disability is expected to increase from 15,227 in 2017 to 16,660 in 2035. The greatest increase in prevalence will occur within the 65+ age groups.

Unmet needs and service gaps

Transforming Care: The Transforming Care agenda remains a significant influence on the future provision and planning of services for people with learning disabilities. The development of community based services to enable people to be supported in or near their own communities remains an area for future development via the Transforming Care Partnership. It is important to note it is not necessarily about the creation of more services, but the development of different ones with enhanced skills and training.

Accommodation and Support: People with learning disabilities are less likely to be homeowners and more likely to live in places over which they have less secure tenure. Nottinghamshire County Council will continue to work with social, private and residential providers to support the availability of properties in areas where people feel safe and where they have access to support.

Continued work is also required to ensure that out of county inpatient or care home placements are necessary only in very exceptional circumstances.

Population Health: Breast cancer screening rates remain disproportionately low for people with learning disabilities. Type 2 diabetes rates remain higher for people with learning disabilities.

Employment: There is a need to ensure that people with learning disabilities have enhanced opportunities to gain skills and support, to get a job and remain employed.

Future service provision: There are known challenges with staff recruitment and retention within care and support services in Nottinghamshire. Provider training and resilience is being reviewed to support Nottinghamshire providers, ensuring there is adequate capabilities in the local workforce to support very complex needs.

The commissioning of an additional unplanned care bed is currently being reviewed.

Planning for transition services: Further work is required for people in transition when moving from Children’s to Adult services, to ensure the correct support and service are available to eligible adults.

Recommendations for consideration by commissioners

You can find an easy read version of the chapter here on the LD partnership board website.

James Wheat (Commissioning Officer, Adult Social Care and Health)

Mercy Lett-Charnock (Commissioning Manager, Adult Social Care and Health)