Design: Secondary analysis of national primary care data, January 2022 to November 2025
Population: All general practices in England; about 374,763 people on learning disability registers
Primary outcome: Register size and annual health check uptake
Effect: Registers 0.588% of patients (¼–⅓ of expected prevalence); uptake 80.7% adults, 71.6% aged 14–17

This analysis of public NHS England data from January 2022 to November 2025 examined learning disability registers and annual health checks, which general practices are paid to offer to everyone on the register aged 14 or over.

Registers grew by 30.5% among 14 to 17 year olds and 14.5% among adults, reaching 0.588% of all registered patients (374,763 people). That is still between a quarter and a third of expected prevalence. Health check uptake rose slightly, from 79.1% to 80.7% in adults and 68.1% to 71.6% in teenagers. Uptake varied by region but not by deprivation or practice size.

People with intellectual disability die much younger than others, often from treatable conditions. The first barrier is simply being identified. In India, where no comparable register exists, the lesson carries over: a practice cannot offer extra care to people it has not recorded.

Record intellectual disability as a coded diagnosis whenever it is known, including from school or family history.
Offer an annual health review to every patient with intellectual disability from age 14.
Pay attention to teenagers, whose check uptake lags adults and who are moving to adult services.
Use the review to check weight, epilepsy, constipation, dental health, vision, hearing and medication burden.
Adjust consultations: longer appointments, easy-read information and a carer present where the patient wishes.

Why it matters

The group with the greatest avoidable mortality is still largely invisible to the practices meant to protect them.

The statistics, in plain English

These are counts from national data, not a trial. Uptake percentages describe everyone on the registers, so the true proportion of all people with learning disability receiving a check is much lower, because most are not registered.