People with learning disabilities are one of the most vulnerable groups in society, often experiencing health inequalities, social exclusion and stigmatisation. In general, people with learning disabilities have greater and more complex health needs than the general population; often these needs go unidentified and untreated. Life expectancy is shorter for people with learning disabilities than the general population, and adults with learning disabilities often experience barriers to accessing healthcare services, and poor levels of care and are more likely to die from a preventable cause than the general population.

It is estimated there are about 1.3 million people with a learning disability in England, including over 950,000 adults aged 18 years or over. The number of people with learning disabilities recorded in health and welfare systems is much lower (Learning Disability – applying all our health, PHE, 2023).

Many people with a learning disability:

  • Are under served in access to healthcare, and experience high levels of health inequality.
  • Many of these will have considerable, and often multiple, physical and mental health conditions and are also at increased risk of developing chronic conditions from both genetic and lifestyle factors.
  • Experience poorer health than the general population, and will die at a younger age (Impact report on People with a Learning Disability, NICE, 2021).

They are also less likely to be working, more likely to live in poverty, more likely to experience chronic loneliness and more likely to be bullied and discriminated against (Learning Disability – applying all our health, PHE, 2023).)

Social care for adults with learning disabilities is one of the highest areas of spending for local authorities at a time when funding to local authorities is reducing. Adults with learning disabilities may need extensive support from family, informal carers or paid care staff to live independently or safely.

Key Messages

  • There were 4,171 patients in County Durham registered with GPs as having a learning disability in 2022/23 (QOF register). This gives a prevalence of 0.74% in County Durham, the same as the North East and higher than England (0.56%).
  • The number of people registered with a learning disability in County Durham has been rising over time, with a near 24% increase in the number of people with LD between 2016 and 2023.
  • In 2020 there were around 3,450 children with learning difficulties known schools in County Durham, at a rate of 47.4 per 1,000 children. This was higher than the North East (40.3 per 1,000) and England (34 per 1,000). For more detailed information relating to Special Education Needs and Disabilities see our SEND JSNAA content and Insight Report.
  • 8% of people with learning disabilities living in County Durham live in their own home or with their family (2022/23), similar to the North East (88.4%) and higher than England (80.5%).
  • As at February 2023 almost 73% of the learning disability population in County Durham eligible for Health Check had received one.

Factsheet: New report to follow

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Why is it important

Having a learning disability affects the way a person understands information, and how they communicate. This means they can have difficulty understanding new or complex information, learning new skills, or coping independently. A learning disability can be mild, moderate, and severe or a profound and multiple learning disability (PMLD) – in all cases, a learning disability is lifelong.

Someone with a mild learning disability will be able to talk easily and look after himself or herself, but may need longer than usual to look after themselves. Whereas someone with PMLD may have severe difficulties seeing, hearing, speaking and moving and therefore need complex health and social care support.

Evidence suggests that:

  • Compared with the general population, people with a learning disability were 3 to 4 times as likely to die from an avoidable medical cause of death. Most of the avoidable deaths in people with a learning disability were because timely and effective treatment was not given (NICE Impact Report on People with Learning Disabilities, 2021). Compared to the wider population, the average age at death for people with a learning disability is 23 years younger for men, and 27 years younger for women (NICE Impact Report on People with Learning Disabilities, 2021).
  • Age at death varies with the severity of the condition but life expectancy rates are particularly poor for those with moderate to severe Learning Disability – around 3 times higher than the general population (Marmot, 2018).
  • For people with a learning disability during 2020, COVID-19 was the leading cause of death for males aged 35 or over and females aged 20 and over (NICE Impact Report on People with Learning Disabilities, 2021).
  • 57% of people in a mental health hospital with a learning disability, autism, or both have been there for over 2 years (NICE Impact Report on People with Learning Disabilities, 2021).

People with learning disabilities have individual strengths and abilities. These should be recognised alongside meeting any support needs that are identified. Care and support services for people with a learning disability should be person-centred, empowering them to make their own choices about what’s important to them in their life.

Mencap describes a learning disability as “a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life. People with a learning disability tend to take longer to learn and may need support to develop new skills, understand complicated information and interact with other people”. 

Nationally the policy direction for people with a learning disability (including those with autism) remains one of a human rights-based approach and one where ‘adults, children, and young people with a learning disability, and autistic adults, children and young people should be equal citizens in their communities’ as referenced in the ‘Building the Right Support Action plan 2022’ (HM Government, July 2022).

How does this topic link to our strategies and plans?

Growing Up in County Durham Strategy (2023-2025). A high level partnership plan which explains what we are going to do to achieve our vision for children, young people and their families.

Local Strategies

National Strategies

Evidence base ‘what works’

National Institute for Health and Care Excellence (NICE) guidance.

Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges (NG11). This guideline covers interventions and support for children, young people and adults with a learning disability and behaviour that challenges. It highlights the importance of understanding the cause of behaviour that challenges, and performing thorough assessments so that steps can be taken to help people change their behaviour and improve their quality of life. The guideline also covers support and intervention for family members or carers. To help increase access to healthcare, this NICE Guidance on challenging behaviour and learning disabilities recommends that people with a learning disability should be offered an annual health check.

Mental health problems in people with learning disabilities: prevention, assessment and management (NG54).  This guideline covers interventions and support for children, young people and adults with a learning disability and behaviour that challenges. It highlights the importance of understanding the cause of behaviour that challenges, and performing thorough assessments so that steps can be taken to help people change their behaviour and improve their quality of life. The guideline also covers support and intervention for family members or carers. It also sets out how the annual health check should identify physical and mental health problems.

Care and support of people growing older with learning disabilities (NG96). This NICE Guidance relates to care and support for adults with learning disabilities as they grow older. It covers identifying changing needs, planning for the future, and delivering services including health, social care and housing. It aims to support people to access the services they need as they get older.

Learning disability: care and support of people growing older (QS187). This NICE Quality Standard sets out the minimum elements that should be included in health check protocols. It covers identifying, assessing and regularly reviewing the care and support needs of people with a learning disability as they grow older.

Transforming Care key documents (Local Government Association)

Social Care Institute for Excellence (SCIE) 

Prevention for people with learning disabilities

 Making choices, being informed:

 Promoting independence and wellbeing:

 Connecting individuals and communities: