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Annual Health Checks

There is a national expectation that proactive annual health checks (AHCs) for people with a learning disability should be taking place. All people with a learning disability aged 14+ are eligible for this annual health check. 

Why are Annual Health Checks important? 

Health inequality remains a concern for people with a learning disability who on average die 15-20 years sooner than the general population and often experience poorer health. 

The national LeDeR report published in 2022 showed the average age of death for people with learning disabilities was 62.9 in England. On average, the life expectancy of women with a learning disability is 26 years shorter than the general population and for men 22 years shorter than the general population. 

The mean age of death of people with a learning disability in Coventry and Warwickshire in 2022/23 was 61.5 years for men and 62.7 years for women.  Unfortunately, often this is not due to complex co-morbidities but due to preventable, treatable conditions. 

The CIPOLD Inquiry (2013) cited that people with a learning disability are three times more likely to die of a cause that could have been avoided than the general population. 

Delivering Annual Health Checks to people with a learning disability  

NHSE advise that where the check can be delivered safely on a face-to-face basis, this remains the preferable delivery model for AHCs.  

Practices are required to use their clinical judgement to determine the most appropriate method for delivery of the AHC, also considering whether the patient would benefit from a home visit as a reasonable adjustment. 

Guidance issued by NHSE Midlands on 19th June 2020 confirms that GP practices can continue to be reimbursed for the delivery of the checks, as long as the requirements of the DES are met. 

It is essential that any AHCs that are performed are in line with the minimum requirements of the DES to ensure a uniform approach and that CQRS claims will be valid. 


A successful Annual Health Check would include: 

Before the AHC 

  • Invitation to the AHC being in a format accessible to the patient. 
  • Informing the patient that they can bring a carer or someone for support with them to the AHC.
  • Offering reasonable adjustments to be made, e.g., an appointment time that best suits the needs of the patient, longer appointment time, or a quiet area in which to wait.
  • Sending a pre-health check questionnaire to the patient, ahead of their appointment. 

During the AHC 

  • Accurate and appropriate recording of the patient’s ethnicity (it is now a requirement that all individuals have their ethnicity recorded during their AHC).
  • The use of reasonable adjustments to support the patient (and recording in the system of any reasonable adjustments made, for future reference and use). You can read more about reasonable adjustments here
  • Using and following an appropriate AHC template that covers all intended areas of the AHC, e.g., Ardens, or a locally produced template. Further information can be found here

Following the AHC 

  • Creation and completion of a Health Action Plan to include any actions from the AHC. 
  • Copy of the Health Action Plan to be saved on EMIS and also to be given to the patient. 
  • Outcomes and actions to be followed-up on, e.g., any blood tests to be ordered. 
  • Any feedback provided by the patient’s/their carer’s experience of the AHC to be gathered and recorded (and acted upon where appropriate). 

Support and Resources 

Historically, local uptake/delivery of AHCs has been poor and performance has been far from the national ambition of 75% delivery across the learning disability population, however 2023/24 saw a delivery of 81%, evidencing a marked improvement in the uptake of these important health checks across Coventry and Warwickshire. 

The Integrated Care Board in Coventry and Warwickshire is committed to improving the quality of AHCs and has been working collaboratively with Learning Disability Nurse resource on a project to evaluate some of the AHCs that have taken place at practices. 

You can contact the Community Learning Disability Team Manager for your practice’s local area on the number below with any general enquiries and support with reasonable adjustments for people with a learning disability. 

  • Coventry & Rugby: 02476 324380 
  • North Warwickshire: 02476 315867 
  • South Warwickshire: 01926 317746 

To make a referral for a specific patient, please use the following details:

Tel: 0300 131 2320 (Monday – Friday, 9am – 5pm, excluding bank holidays)

A range of useful resources including a full GP resource pack, leaflet to send to patients, easy read pre-health check questionnaire and a health action plan template are available on the Learning Disability Services webpage

The Community Learning Disability Team also delivers several virtual Learning Disability Awareness sessions each year; you can find details of these via the Coventry & Warwickshire Training Hub