Steps for primary care staff to complete LD checks

1. The health check register

Only patients known to the local learning disability (LD) services are eligible for health checks as part of the DES scheme. Practices are required to produce a Health Check Register to distinguish those eligible for health checks from those on their LD QOF register. It is often the case that some patients appearing on LD QOF registers may not be eligible for the separate and additional DES health check register.

2. Additional searches for learning disabled patients

This link for READ CODE guidance (65KB) provides a list of READ CODES for practices to search for patients who have a diagnosis of a syndrome or condition that may indicate the presence of a learning disability, for example Congenital Cerebral Palsy (Read code = F23). It is extremely useful to carry out these additional searches on the 13 ‘Conditions’ read codes listed.

3. Confirming your LD health check register

On completion of steps 1 and 2 above, contact your local Strategic Health Facilitation Lead:

Bexley & Greenwich
Mark Bradley (Health Facilitation Coordinator)
Email: mbradley1@nhs.net
Tel: 0208 269 3349

Greenwich only
Louise Stockdale (Health Facilitator)
Email: louise.stockdale@nhs.net
Tel: 0208 921 4860

NOTE:
There is no dedicated Strategic Health Facilitation Lead Post in Bromley. As such, please contact the local Bromley Community LD Team – 01689 853388, stating the practice name and requesting confirmation of your LD health check register.

Referring patients to the relevant LD team is possible via the referring to learning disability services link. However, referrals must be on the basis of presenting unmet need, requiring specialist LD service intervention rather than ‘suspected presence of a learning disability’. Details of each LD team can be found in the Find Services page.

Once your register has been confirmed you are ready to begin the health check process.

4. Training

Bespoke training, to your practice needs, can be arranged. Additionally, LD nursing support is offered with initial health checks as part of the training process. Training certificates are offered on completion of the training. The following practice staff should have completed DES Health Check training: The lead GP, lead practice nurse and either the practice manager or senior receptionist/person responsible for the maintenance of the registers. Training is provided by the local Strategic Health Facilitation Lead, involving people with learning disabilities and can be delivered in-house. If the appropriate practice staff have not been trained, this should be arranged immediately. Failing to do so, could result in payments not being made by the local GP contracting lead.

5. Health check invitations

The health check invitation (DOC, 2.45MB) letter has been written in an accessible format for practices to invite their learning disabled patients for health checks.

It is also recommended that practices attach the pre-health check questionnaire (4.3MB)  in order to:

a) prepare patients for their health check appointment,
b) reduce anxiety related to the nature of the health check,
c) ensure the health check is comprehensive, in line with the DES Guidelines (380KB)
d) reduce the appointment time.

It is expected that patients, with support from their carers, will arrive with relevant information related to their health and medical history etc, thus, reducing the need to spend time gleaning this information during the Health Check appointment.

6. Carrying out the health check

The Health Professional carrying out the health check is responsible for ensuring the health check is comprehensive, as described in the DES Guidelines. The recommended format for the health check is the Cardiff Health Check (32KB). As this is not yet in an electronic template for Vision or EMIS purposes, practices will satisfy their requirements by using the available electronic guidelines/templates in addition to the pre-health check questionnaire (4.3MB). The areas of health covered in this questionnaire should be recorded in the patient notes.

7. Personal health profiles and health action plans

The DES states that Health Checks should ‘integrate with an individual’s Personal Health Record and Health Action Plan’. Personal Health Profiles have been designed and provided with this purpose in mind. Practices will be required to demonstrate that they have offered Personal Health Profiles and completed Health Action Plans at the time of the Health Check Appointment. Audits will be carried out throughout the financial year.

Information on Personal Health Profiles and Health Action Planning can be viewed here.

8. Reporting when complete

Progress with Health Checks should be reported to the local Strategic Health Facilitation Lead in addition to the GP contracting team at the local GP contracting lead. The GP contracting team leads for the DES LD Health Checks are:

Greenwich
Nick Langford 

Bexley
Mike Nelson

Bromley
Sally Ann Edwards

Performance management is the responsibility of the local GP contracting lead. The Strategic Health Facilitation leads will provide whatever advice and guidance is necessary to ensure the health checks are of sufficient quality, in line with the DES guidance. This includes, in-house training, some clinical support in relation to the health check process and support to ensure that registers are developed appropriately.