The UK general practitioners contract included a pay for performance element for management of long-term conditions, according to best-practice indicators, defined by the Quality and Outcomes Framework (QOF). This study uses QOF to measures good practice for adults with learning disabilities compared with the general population at two time points.
Patient records of adults with learning disabilities registered with participating general practices were extracted and analysed in 2010 (n=721) and in 2014 (n=3,638) to determine management of long-term conditions according to QOF indicators. Comparisons at both times were made with the general population from the same health board. Additionally, they were compared over time, and with the general population in 2014, using Fisher's Exact test and ordinal regression.
Management improved for adults with intellectual disabilities over time (OR = 5.32; CI = 2.69–10.55), but not for the general population (OR = 0.74; CI = 0.34–1.64). However, it remained poorer, but to a lesser extent, compared with the general population (OR = 0.38; CI = 0.20–0.73 in 2014, and OR = 0.05; CI = 0.02–0.12 in 2007–2010). In 2014, health care was comparable to the general population on 49/78 (62.8%) indicators.
High quality management of long term conditions is essential to maintain and improve health. The healthcare inequality gap between people with learning disabilities and the general population narrowed between 2010 and 2014, though people with learning disabilities still experienced poorer management of their long term conditions.
Project information last updated August 2022.
Laura is a Lecturer in Clinical Psychology at the University of Glasgow, and an affiliate of the Scottish Learning Disabilities Observatory, having joined the team in 2015. With the Observatory, Laura was involved in projects looking at the health of people with learning disabilities in a number of large data-sets, including primary health care records, Scotland's 2011 Census and health records of people born with Down Syndrome in Scotland over a 25 year period. Laura studied Psychology and has extensive experience of working with people with learning disabilities in her previous roles, for example, as a Befriender, a Learning Assistant and an Assistant Psychologist. Read more about Laura at the link below
Anna set up the Scottish Learning Disabilities Observatory with funding from the Scottish Government. She wants the Observatory to make Scotland fairer and healthier for people with learning disabilities and their families, by: Finding out the health problems people have Finding out how good or bad health care is Telling people about health and health care problems Finding ways to make health and health care better Checking if health gets better or worse over time Helping the Scottish Government, and staff who provide health and social services, to get it right for people with learning disabilities Anna is a doctor. She has done a lot of studies on the health of people with learning disabilities. Anna’s full name is Professor Sally-Ann Cooper.
Angela was formerly the Director for Policy and Impact for the Scottish Learning Disabilities Observatory and remains an affiliate team member, having moved in 2024 to work with the Scottish Government leading the development of annual health checks and learning disabilities data. Angela is interested in how evidence is used in policy making and was involved in many projects at the Observatory. These included: Understanding the impact of Covid-19 on people with learning disabilities The Research Voices Project Helping to set up the SPIRE learning disabilities data project Analysing information about drug prescribing for people with learning disabilities
Craig is a Professor of Neurodevelopmental Psychiatry in the School of Health and Wellbeing at the University of Glasgow. His work focuses on using evidence from research to inform the development of interventions and policy to improve the health of people with neurodevelopmental conditions. Craig has worked on clinical trials of complex interventions, such as psychological therapies, weight management and health checks in primary care. Evidence from epidemiological research has been central to the development of these clinical trials and his work with SLDO centres on how to use Scotland’s national datasets to understand and tackle the health inequalities experienced by people with neurodevelopmental conditions.
