One way to understand the impact of inequalities is to look at how social exclusion impacts on a specific group.
- You can discover the issues affecting people with learning disabilities in the overview below
- Find information on relevant agencies and communities
- See how others are turning principles into action in the good practice examples
- Check credible sources for guidance
- Track the social inclusion programme in the UK in the policy section
- Hear from the experiences of people from this group in the voices section.
Who are they?
People with learning disabilities are a diverse group and vary widely in their abilities, affecting the kind of support each person needs (Royal College of Nursing 2010).
The Department of Health in England (DH 2001) defined learning disability as: a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence) along with a reduced ability to cope independently (impaired social functioning). The onset of disability is considered to have started before adulthood, with a lasting effect on development. This definition includes IQ and functional aspects that make it distinct from the use of the term "learning difficulties" which has a far wider application in education (DH 2001).
The terms "mild", "moderate" and "severe or profound" learning disabilities appear to suggest distinct categories for learning disability but in reality these do not adequately describe the range of impairments or disabilities this group may have. Someone with autism, for example, who has learning disabilities may have significant social difficulties and appear to have moderate learning difficulties, yet may be able to look after their own personal care and everyday needs quite independently (RCN 2010).
Learning disability is one of the most common forms of disability and affects up to 1.5 million people in England alone (Emerson and Hatton 2008). Over 200,000 children in England (2.6 per cent) have a primary special educational need associated with learning disabilities. This is likely to be a significant underestimate (Emerson and Hatton 2008).
People with learning disabilities are living longer. In the 1930s average life expectancy was estimated to be less than 20 years of age (Holland 2008). Mean life expectancy is now estimated to be 74, 67 and 58 for those with mild, moderate and severe learning disabilities respectively (Bittles et al 2002). The number of adults with learning disabilities is predicted to increase by 14 per cent between 2001 and 2021, resulting in more than a million people with learning disabilities by 2021 (Emerson and Hatton 2008).
How are they affected by social exclusion?
People with learning disabilities are 2.5 times more likely to have health problems than other people (Disability Rights Commission 2006). Yet recent reports have highlighted evidence that people with learning disabilities have higher levels of unmet need and receive less effective treatment, despite legislation that explicitly sets out a legal framework for the delivery of equal treatment (Disability Rights Commission 2006 and 2007, Mencap 2007, Michael 2008).
What is being done?
In June 2011, undercover filming by the BBC in Winterbourne View private hospital revealed a pattern of serious abuse and vulnerablity of its residents. In June 2013, The Department of Health, NHS England, Local Government Association, Association of Directors of Adult Social Services, Care Quality Commission and the National Forum of People with Learning Disabilities issued a statement emphasising a commitment to making the lives of people with learning disabilities better and safer, and improving their health and care. View the statement - Winterbourne View – 2 years on.
The NHS Mandate (DH, 2012a) set specific objectives for improving safeguarding practices in the NHS, reflecting a commitment to prevent and reduce the risk of abuse and neglect of adults. "The NHS Commissioning Board’s objective is to ensure that CCGs work with local authorities to ensure that vulnerable people, particularly those with learning disabilities and autism, receive safe, appropriate, high quality care." (DH, 2012b, p.16).
Mencap's 'Getting it right' campaign aims to ensure that people with a learning disability receive the level of health care they have a right to. 'Getting it right' calls on health professionals to commit to a charter that will help them work towards better health, wellbeing and quality of life for people with a learning disability (Mencap, 2010). Mencap has worked with healthcare professionals and Royal Colleges to develop the Getting it right charter. The charter spells out the nine key activities that all healthcare professionals should do to ensure that there is equal access to health. View the Getting it right charter (PDF 158KB) (see how to access PDF files).
The items in this reference list are available online. They were last accessed on 5 November 2013. Some of them are in PDF format - see how to access PDF files.
Bittles AM et al (2002) The influence of intellectual disability on life expectancy. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57(7) pp.M470-72.
Department of Health (2013) Partners issue joint statement 2 years after Winterbourne View. London: The Department.
Department of Health (2012a) NHS Mandate. London: The Department.
Department of Health (2012b) The Mandate. A mandate from the Government to the NHS Commissioning Board: April 2013 to March 2015 (PDF 660KB). London: The Department.
Department of Health (2001) Valuing people: a new strategy for learning disability for the 21st century. London: The Department.
Disability Rights Commission (2006) Equal treatment: closing the gap. Health formal investigation report. London: Disability Rights Commission.
Disability Rights Commission (2007) Equal Treatment: Closing the Gap - One Year On (PDF 130.1KB). London: Disability Rights Commission.
Emerson E, Hatton C (2008) People with learning disabilities in England (PDF 571.9KB). Lancaster: Centre for Disability Research (CeDR), Lancaster University.
Holland T (2008) Mental Capital and Wellbeing: Making the most of ourselves in the 21st century (PDF 187.1KB). London: The Government Office for Science, Foresight Mental Capital and Wellbeing Project.
Mencap (2010) Getting it right. London: Mencap.
Mencap (2010) Getting it right charter. london: Mencap.
Mencap (2007) Death by indifference. Following up on the Treat me right! report. London: Mencap.
Michael J, Sir (2008) Healthcare for all. Report of the independent inquiry into access to healthcare for people with learning disabilities. London: Department of Health.
Royal College of Nursing (2010) Mental health nursing of adults with learning disabilities (PDF 472KB). London: RCN.