Learning Disabilities DES

Learning DES FAQs

Learning Disabilities DES guidance pcc website

http://www.pcc.nhs.uk/clinical-des-for-learning-disabilities

 The difficulty with the Learning Disability DES is that you will be funded for medicals carried out on patients on the Local Authority Learning Disability Register.  PCTs have been trying very hard to work with the Local Authority to identify these patients and inform the Practice of the patients registered with the practice who are on the register.  It is clear that there will be a substantial number of patients who would qualify under the terms of the DES,  if they were on the Local Authority Register.

Some PCTs have suggested that Practices should identify these patients and then send the list  of patients, to the Local Authority for the patients to be placed on the Learning Disabilities Register.  The rationale is that this is in the patients best interests and the confidentiality issue is covered by the Local Authorities Governance arrangement.

The LMC's advice is that you should identify the patients who qualify for this DES but are not on the Local Authority Register, you should then gain the consent* of the individual or their carer before you send there names, addresses and clinical details to the Local Authority.  It would also be helpful if you could inform the patients or their carer of any benefit to them being registered with the Local Authority.

One PCT has suggested this is not necessary, as there is clear gain by the individual having access to an annual review and medical, and as such you are permitted to act in the best interests of the patient.  Unfortunately I do not think this is the case.  The registration allows the practice to claim a fee, an annual medical and review could take place without this but the practice would not be paid.

Hants PCT have produced a Q&A document about these Health Checks available here

(* On a legal point nobody may give consent on behalf of another adult, even if they lack mental capacity. If the patient lacks capacity then the GP may make a "best interests" decision based on a statutory check list which includes taking into account the carer's wishes.  See mental capacity)

NFW/FS Feb 08