Annual health checks: Frequently Asked Questions…and answers

What is the annual health check for people with learning disabilities?

Young people aged 14 or over with a learning disability are entitled to a free NHS health check every year. A GP and/ or a practice nurse will usually carry out the check. It is a chance for you and your young person to talk to the GP and nurse about any health worries and for GPs to spot and treat any health problems early. 

Read more in our Annual Health Check factsheet

Why are annual health checks so important?

Studies show people with learning disabilities have poorer physical and mental health than other people and die younger. Research also shows people with learning disabilities are at greater risk if they get Coronavirus.

Many of these deaths are avoidable. Sometimes health and medical problems get missed because professionals only see people's disability. Health checks are designed to help tackle these 'health inequalities' by detecting and treating health problems earlier.

At the moment, only 53% of people with learning disabilities eligible are having annual health checks.

What do they check?

The GP or nurse will do a physical check-up, including weight, heart rate, blood pressure and take blood and urine samples. They may ask about common health problems like constipation or about epilepsy or problems with swallowing. They will ask about medications and check whether your young person's vaccinations and screenings are up to date.

If your child has asthma or diabetes, the GP or nurse will check how it is going. They will check to see if they have other health appointments, such as physiotherapy or speech therapy, and ask if family carers are getting the support they need. They may also advise on healthy eating, exercise, contraception and stopping smoking.

What happens after the annual health check?

After the check-up, the GP should provide you and your young person with a Health Action Plan to help them know what they need to do to stay healthy.

This may include information on managing any health conditions and detail support they may need to do this. It will state who must provide the support or deliver the service and by when. It may include information on diet, exercise, staying safe and when to go for sight, hearing, and dental checks.

How can I make sure my son/daughter is invited for a health check?

Speak to your GP to ask for your child to be added to the GP learning disability register. They can be added at any age. They will start receiving invitations for an annual health check after their 14th birthday.

If your child is over 16, they may need to ask for themselves, or if they are unable to make this decision, talk to their GP about making a 'best interests' decision using the Mental Capacity Act (2005), which should involve family carers.

Who is eligible for the learning disability register and annual health check?

Anyone with a learning disability aged 14 and over, with or without a formal diagnosis, can get a free annual health check. They need to be on the practice leaning disability register to receive an invitation. You can ask for your child to be registered.  

If it is unclear whether your child has a learning disability, ask the GP to assess them with this simple Learning Disability Register Inclusion Tool

Our GP refused to add my autistic son to the practice learning disability register. Is this correct?

Anyone with a learning disability can be added to the register even if they do not have a formal diagnosis. A learning disability is defined has having have "a significantly reduced ability to understand new or complex information and to learn new skills with a reduced ability to cope independently, and this must have started before adulthood." 

If it is unclear whether your autistic son or daughter has a learning disability, the GP can assess them using this simple Learning Disability Register Inclusion Tool. The Department of Health is planning an annual health check for autistic people, but this is still in the pipeline.

How will this annual health benefit my son/daughter?

As well as detecting and treating health problems early, annual checks can make your young person more confident about attending GP appointments. It is a chance for the GP and practice staff to get to know them and their care needs better.

They will record information about any reasonable adjustments and preferred communication methods. For example, they might need longer appointments, easy read information, or a quiet place to wait before their appointment.

Are there other benefits?

The check should lead to a Health Action Plan that can be used to shape health outcomes in your young person's Education Health and Care plan.

If your young person needs reasonable adjustments to attend appointments, these can be highlighted in the practice Summary Care Record to help other health services, like emergency services, understand how to work with your son or daughter.

You child being on the register also helps identify you and their siblings as carers. The GP will ask for your young person's consent to add this information to the record.

What is the GP learning disability register?

GP learning disability registers are a record of all the people registered with the practice that have a learning disability. This is different from the Register of Disabled Children that all local authorities are required to keep.

The GP learning disability register enables practice staff to identify children, young people and their families who may need extra help or support to access healthcare. Anyone with a learning disability, regardless of whether they have a formal diagnosis, can ask to go on it. Since 2015, the register should include all ages, not just those over 18.

My GP says they only do annual health checks over the phone. Is this right?

Practices may ask you to complete a pre-check questionnaire to gather information about your son or daughter before the health check, either by post, email or over the phone in advance of the health check. This is not the full check.

It is important they also measure your young person's height weight and heart rate, which needs to be done in person,  GPs can learn a lot about someone's health by looking at their skin tone, eyes and the way they move.

The practice should ask you and your young person what is best or feels safer for them. For example, you may want half the appointment at the GP surgery and half via video link. Or you may prefer to request an online check. You have the right to request reasonable adjustments of this kind to enable your young person to have their health check.

Find out more about reasonable adjustments in our guide Making GP surgeries more welcoming

Our practice says they do not do annual health checks for people with learning disabilities. Where can we get the check done?

Most GP surgeries offer annual health checks to people with a learning disability and are paid for carrying them out. However, GP surgeries do not have to offer this service.

If your GP surgery has not offered your young person an annual health check, you can ask them to provide one. If they say 'no', ask your local community learning disability team or learning disability nurse for advice. They should be able to help you access an annual health check.

My son gets stressed and overwhelmed attending medical appointments. How can I make sure he does not miss out on his health check?

The practice must make reasonable adjustments (or changes) to make sure that someone with a learning disability can have their annual health check. A reasonable adjustment might include providing information in easy read, conducting the check by video, providing a longer appointment or sending you pictures of the practice and the staff who will conduct the check or providing a quiet waiting area.

Find out more about reasonable adjustments in our leaflet Making GP surgeries more welcoming

My teenager health check was poor quality and superficial. What should a good quality annual health check look like?

Have a look at the Royal College of GP's toolkit for GPs on how to conduct a good quality annual health check for someone with a learning disability. Before the health check, you and your young person might want to jot down any health worries or issues you want to raise with you GP and ask them if these can be investigated or added to the Health Action Plan.

Can my 10-year-old child be added to the GP Learning Disability Register?

You can ask for you child to be added to the practice learning disability register at any time. The earlier the better. This should automatically generate their invitation for an Annual Health Check when they turn 14, and it will help the practice understand your child's needs better when they attend appointments.

Can GPs offer tailored health checks for certain types of conditions?

The GP or practice nurse may do extra tests for young people if their learning disability is linked to a specific health risk. For example, if your young person has Down's syndrome, they can be tested to see if their thyroid gland is working properly. Tailored health checks may be offered to people with Cerebral Palsy, Foetal Alcohol Syndrome, Fragile X Syndrome, Prader-Willi Syndrome, Rett Syndrome and Williams Syndrome.

My son has complex medical needs. He already attends lots of hospital appointments. What is the point of another medical appointment?

Annual health Checks for people with learning disabilities are entirely voluntary. If you feel your young person's general health needs are adequately monitored by their specialist/s, you may decide this health check is not for them.

Ask yourself whether their consultant or specialist nurse routinely asks about your child's eye and dental health and diet. It may be a good idea to introduce your young person to their GP, ensuring GPs find out more about their patients with more complex needs.

The Health Action Plan should include reminders for eyesight and dental appointments which may sometimes get overlooked in busy specialist clinics.

Are there any leaflets or videos I can show young person what to expect during their annual health check and why it is important?

Here are some of our favourites. Supercharged Me is great for explaining health checks in a fun way. We also like this video Health is Everyone's Responsibility and Mencap's Easy Read guide from Mencap

Parents can also find out more from our Annual Health Check factsheet and our guide to Making GP surgeries more welcoming