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As NHS England shifts its care model for people with learning disabilities from hospitals to the local community, allied health professionals such as physiotherapists are set to play a vital role. 




"Physiotherapists deliver many key services that enable people with learning disabilities to live independently in their community and these plans should support that important work." That was the verdict of Catherine Pope, Chair of Council of the Chartered Society of Physiotherapy (CSP), commenting on NHS England's plans to move more services for people with learning disabilities out of hospital and into the community, announced in October last year.

Summed up in the report Building the right support, the plans follow on from the Transforming Care strategy, which was formulated in response to the Winterbourne View scandal of 2011. "Children, young people and adults with a learning disability and/or autism have the right to the same opportunities as anyone else to live satisfying and valued lives, and to be treated with dignity and respect," begins the Foreword to the report, which sets out a new community-based service model.

According to the Foundation for People with Learning Disabilities, people with a learning disability are 2.5 times more likely to suffer health problems than the rest of the population. Specialist physiotherapists can help promote physical health and mental well-being, often working as part of multi-disciplinary teams which include psychiatrists, psychologists, learning disability nurses, occupational therapists, speech and language therapists and dietitians.

One of the main areas of focus for physiotherapists is 24-hour posture care, which involves assessment for equipment for optimal positioning day and night, including wheelchairs, seating, orthotic provision and sleep systems.

Another important part of the physiotherapists' role is health promotion, which may include encouraging participation in walking projects, gym sessions, swimming, cycling, horse riding and other physical activities. Following 18 months of research concluding in 2015, a team led by Jennifer Crockett of NHS Greater Glasgow and Clyde concluded that physiotherapists have a key role to play in promoting exercise to prevent falls involving people with intellectual disabilities.

An inspiring blog post on the Mencap website is just one example of the difference that can be made to the lives of people with a learning disability by specialist health professionals such as physiotherapists and speech and language therapists.

Professional guidance


The CSP is working with the Association of Chartered Physiotherapists for People with Learning Disabilities (ACPPLD) to develop guidance for physiotherapists to support them in working with people who have a learning disability. "Physiotherapists will see an increasing number of patients with learning disabilities so we are working with ACPPLD to put together simple advice to members on how to assess and approach people with learning disabilities," explained Natalie Beswetherick, CSP Director of Practice and Development.

On 14 January the Department of Health published a progress report on its Think Autism updated strategy. The report states that local authorities and the NHS should be providing general autism awareness training to all frontline staff in contact with adults with autism. "We welcome any initiative that raises awareness of learning disabilities and autism," commented ACPPLD Chair Jenny Tinkler. " Healthcare staff working in mainstream services should have an understanding of autism, be aware of the impact it can have on somebody attending appointments and realise the importance of making reasonable adjustments."

With approximately 1.5 million people in the UK having a learning disability, helping more of them stay fit and healthy could have a significant impact, not least in reduced hospital admissions. That means making the most of the specialist skills and expertise of physiotherapists to achieve positive outcomes.

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