Increasing the uptake of annual health checks in children and young people aged 14-17 years with learning disability

The aims of the research are to a) gather information from multiple stakeholders to better understand why uptake of annual health checks is low in children and young people (CYP) aged 14-17-years with a learning disability, and b) co-design an intervention to increase uptake and quality. Background

Despite an increasing trajectory in the uptake of annual health checks over recent years, there are particular groups for whom the uptake lags behind the national average, including CYP aged 14-17-years. The proposed research directly addresses the needs identified in the Demand Signalling report which calls for increased understanding of how to increase uptake of annual health checks, how to increase accessibility for harder-to-access groups (e.g. CYP), the best delivery model, and the impact of annual health checks (NHS England, 2022).

Methods

The research has 2 Phases. Phase 1 (months 1-20) involves an extensive information-gathering exercise adopting a mixed-methods design across three Work Packages which, together, incorporate views from multiple stakeholders.

• Phase 1, Work Package 1: We will conduct a) case studies with 6 General Practices including documentary analysis of key resources and semi-structured interviews with primary care staff, b) a focus group with NHS England and NHS Trusts, and c) analysis of national general practice data.

• Phase 1, Work Package 2: We will conduct semi-structured interviews and an online survey with family carers of CYP with a learning disability, and use Talking Mats communication tool to explore views of CYP with a learning disability.

• Phase 1, Work Package 3: We will synthesise the evidence to answer research questions relating to existing processes, barriers and enablers, key ingredients of accessible annual health checks, and perceived impact. Based on this, an intervention to increase uptake of annual health checks in CYP with a learning disability will be co-designed with a PPI Design Group consisting of family carers, GPs, and representatives from social care and education.

In Phase 2 (months 21-36), we will assess feasibility and acceptability of the co-designed intervention. It is envisaged that the intervention will include support for general practices to implement reasonable adjustments, linkage with special schools, and liaison with family carers. The intervention will be implemented in 15 primary care networks and participants will be 50 family carers and 20 healthcare practitioners from participating sites.

Qualitative data on feasibility and acceptability will be collected via semi-structured interviews developed with a PPI Steering Group. Quantitative data collected will be informed by the PPI Steering Group and may include participant uptake numbers, as well as prevalence of CYP on GP learning disability registers, requests/invitations to an annual health check, and development of an action plan before and after the intervention.

Impact

The research team and the PPI steering group will produce a Guide for primary care practitioners on annual health checks in CYP with a learning disability based on data collected through Phase 1. We will also publish guidelines suitable for use in primary care services and special schools after the project. The study results and these impact outputs will be launched at a ‘Research to Practice’ dissemination event for stakeholders (for primary care practitioners and educational staff).