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Abstract
Objectives To investigate key stakeholders’ views on how to improve access to primary care in general practice settings for people with learning disabilities (or intellectual disabilities). Further to explore how inequalities and barriers in specific areas including annual health checks might be addressed.
Design A qualitative study design was used with data collected during focus groups, interviews and open-response surveys; data analysis was thematic and informed by stakeholder consultation. Processes to facilitate quality included triangulation of stakeholder perspectives, triangulation of data collection methods and checking interpretation of findings with participants.
Setting UK regional services including learning disability organisations, primary care general practitioner (GP) clinical practice networks and supported housing organisations.
Participants Sixteen people participated in the study: four people with learning disabilities participated in a focus group; four relatives completed an interview or survey; eight GPs, practice nurses and supported housing managers participated in interviews.
Results Five overarching themes describing approaches to improve primary care access for people with learning disabilities were identified including: prioritisation, proactivity, innovation and improvement, personalisation and prevention and follow-up. Definitions of themes were described and illustrated with quotes. Ten recommendations informed by the thematic analysis, stakeholder consultation, research and primary care guidance were codeveloped with people with learning disabilities.
Conclusions All stakeholders identified problems, with primary care interfaces being misaligned with the needs of people with learning disabilities. The recommendations informed by all stakeholders can be used to guide development of service provision to better meet the needs of people with learning disabilities in primary care. Future research should explore professionals’ understanding of reasonable adjustments.
- education & training (see medical education & training)
- quality in health care
- qualitative research
- primary care
Data availability statement
Data are available on reasonable request. The data are not publicly available as they contain information that could compromise the privacy of research participants. Some data that support the findings of this study are available on reasonable request from the last author (SH).
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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- education & training (see medical education & training)
- quality in health care
- qualitative research
- primary care
Data availability statement
Data are available on reasonable request. The data are not publicly available as they contain information that could compromise the privacy of research participants. Some data that support the findings of this study are available on reasonable request from the last author (SH).
Supplementary materials
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Footnotes
Contributors SH, SW, JB, KM and GR were awarded funding. SH was chief investigator and is guarantor. SH, SW, JB, KM, KP and GR contributed to conceptualisation and development of data collection materials. SW and JB collected data. SW and SH wrote the first draft of the manuscript. SH, SW, JB, KM, KP and GR contributed during the editing and reviewing process. All authors approved the final manuscript.
Funding This research was funded by DHSC Research Capability Funding from NECS. Dr Sarah Wigham is a Mental Health Fellow funded by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria. Professor Rowlands is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NIHR200173).
Disclaimer The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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