Annual Health Checks for People with a Learning Disability: A Care Staff Guide

People with a learning disability often have more health problems than other people, and are less likely to have them spotted early. They may not be able to explain how they feel, may find healthcare settings frightening, or may have symptoms put down to their disability. The annual health check is one of the simplest ways to catch problems early, and care and support staff can make a real difference to whether it happens and how well it goes.

This guide explains who is eligible, what the check includes, how it is arranged and how staff can help. It draws on the NHS page on annual health checks for people with a learning disability, last reviewed in September 2025.

Who is the annual health check for?

According to the NHS, the check is free, happens once a year, and is for people aged 14 or over who are on their GP practice's learning disability register. Someone who thinks they have a learning disability can ask to be added to the register. The check is optional: a person can choose not to have one.

Being on the register matters because the GP practice uses it to send invitations. If someone you support is not on the register, ask the practice about it with their agreement.

What the check includes

The NHS lists these parts of the health check:

• A physical check, including weight, heart rate and blood pressure.
• A urine sample or blood test, if needed.
• Questions about epilepsy, constipation, swallowing, eyesight and hearing.
• A review of medicines.
• A check on vaccinations.
• A review of conditions such as asthma or diabetes, if relevant.
• A check on other health appointments.
• A check on whether family or carers get the support they need.
• Planning for the move to adult services at age 18.
• General health advice, such as healthy eating.

Many of these topics, such as swallowing, constipation and epilepsy, are things that care staff see every day. Bringing your observations to the appointment can make the check much more useful.

How the check is arranged

The NHS says the GP practice should invite eligible patients. It adds that not all practices are required to offer the check. If the person has not been invited, ask the practice. If the practice refuses, the NHS suggests asking the local community learning disability team, and asking about other GP surgeries in the area that offer checks.

Consent and capacity

The NHS says people are asked for consent before tests, vaccinations or procedures, and before health information is shared with other services. It also says that a parent or main carer may be able to give consent for health information to be shared where the person cannot. For adults in England, decisions made on behalf of someone who lacks capacity must follow the Mental Capacity Act, which means assessing capacity for the specific decision and acting in the person's best interests. Our guide to best-interests decision-making explains the process.

Reasonable adjustments

The NHS gives examples of adjustments that can make the check work for the person:

• Pictures, large print and simpler words.
• Longer appointments.
• A carer present.
• Early or late appointments to avoid busy waiting rooms.

Adjustments are recorded in a health profile or action plan so that staff do not have to be asked for them again each time. Carers can attend as a reasonable adjustment.

The health action plan

After the check, the agreed actions and next steps are recorded in a health action plan, also called a health profile. It also holds the reasonable adjustments that staff should use. A good plan is useful to everyone who supports the person: keep a copy with the care plan and share it, with the person's agreement, when they go to hospital or other appointments.

How care staff can help

The NHS page describes what the check includes, but not the detailed role of support staff. The following points are general good practice and should be adapted to the person and your organisation's policies.

Before the appointment

• Check whether the person is on the register and has been invited this year.
• Explain in the person's preferred way what will happen, using pictures or easy read information where helpful.
• Write down changes you have noticed in eating, drinking, sleep, mobility, mood, continence and behaviour.
• Bring an up-to-date medicines list and any existing health profile.

During and after

• Allow the person to speak for themselves wherever possible and add your own observations afterwards, with their agreement.
• Make sure any follow-up tests or appointments are booked and understood.
• Update the care plan and health action plan, and tell the team what was agreed.

The check also guards against diagnostic overshadowing, where signs of illness are wrongly put down to the person's learning disability. Our guide to diagnostic overshadowing in learning disability explains how to spot and challenge it.

Training and CPD

Supporting health and wellbeing for people with a learning disability starts with understanding. The Oliver McGowan mandatory training sets out the expected baseline, and our CPD pages list further options. Record what you learn in your CPD log and discuss real cases in supervision.

Key points to remember

• The annual health check is free, optional and offered to people aged 14 or over on the GP learning disability register.
• It covers physical measurements, medicines, vaccinations, and topics such as epilepsy, swallowing and constipation.
• The GP practice should invite people; if they do not, ask them or the community learning disability team.
• Reasonable adjustments and the health action plan should be recorded and shared.
• Decisions about consent follow the Mental Capacity Act for adults who lack capacity.

Frequently asked questions

Does the person have to have the check?

No. The NHS says the check is optional, so staff should explain its benefits and support the person's choice.

What if the GP practice does not offer it?

The NHS advises asking the practice, then the local community learning disability team, and asking about other nearby surgeries that offer checks.

Can a carer attend?

Yes. The NHS says carers can attend as a reasonable adjustment, and the check includes asking whether family and carers get the support they need.

This guide is for general information and is not a substitute for clinical advice or your organisation's policies.