Learning Together - A review of the quality of care provided to adults with a learning disability who were admitted to hospital acutely unwell (NCEPOD, 11 June 2026)

Summary

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) reviewed the care of adults with a diagnosed learning disability who attended/were admitted to hospital as an emergency between 1st July and 30th September 2024. Care was reviewed using 666 clinician questionnaires, 366 sets of case notes, 144 primary care questionnaires, 199 organisational questionnaires, 832 healthcare professional survey responses and 82 patient/carer surveys.

Content

Recommendations

1. Accurately record a person’s identified learning disability in the electronic patient record/clinical notes and in learning disability registers/lists. This information should be accessible across healthcare settings to ensure prompt recognition and proactive care for patients with a learning disability on arrival at hospital.
2. Assess and implement reasonable adjustments for patients with a learning disability. This should be undertaken: proactively if the reasonable adjustments have been flagged, and in place when the patient arrives in hospital; as soon as practicable after arrival/admission to hospital and be reassessed throughout the admission.
3. Use decision support tools to aid healthcare professionals when assessing mental capacity in patients with a learning disability. 
4. Consistently and continuously involve people with a learning disability in their care during a hospital admission. This should be from the point of arrival through to discharge. Include:support from carers as appropriate; Reasonable adjustments at all stages, e.g., using communication tools to support conversations. 
5. Commission local learning disability support services to enable equitable access to care for patients with a learning disability who attend or who are admitted to hospital. Consider: using multidisciplinary community learning disability services to provide an in-reach service; upskilling all healthcare professionals to care for people with a learning disability; locally assessing how many patients are seen annually to determine the size of the service needed.