As a service, we often receive referrals from GP’s requesting us to diagnose someone with a learning disability. It has become evident that there is not a clear understanding of what the Community Learning Disability Team are commissioned to do. This information has been developed to enable primary care to gain a better understanding about the service.

Inclusion on the Learning Disability register does not mean that the person will automatically be eligible for specialist learning disability services – that decision is based on the LSCft balance of probability process and they must have an unmet health need that cannot be met by mainstream services. The Community Learning Disability Team do not accept referrals for diagnosis.

The following information has been compiled to summarise the service provision with the aim of alleviating any further confusion for practices. There are three elements to establishing the likelihood someone has a learning disability or not, and all three need to be present:

  1. Evidence of a significant impairment in cognitive functioning that is global in nature, i.e. intellectual impairment. This is usually demonstrated by a score of less than 70 on a recognised cognitive assessment.
  2. Evidence of significant impairment in adaptive functioning. This can be demonstrated by a formal assessment and/or evidence of the level of support a person requires to conduct activities of everyday living.
  3. Evidence of age of onset, prior to 18 years of age. This must be obtained from developmental history and any assessments/reports conducted during the person’s childhood.

To identify whether someone meets the above criterion, the balance of probability tool is used within the Community Learning Disability Team. This is a way of collecting collateral information, and by using the criteria we can establish if the person, on balance of probability, is eligible for input from the Learning Disability Service.

The balance of probability tool is not a diagnostic tool and its completion is not necessary for individuals to be included on the GP Learning Disability Register. The inclusion tool for GPs is used for this purpose.

In addition, to access the Community Learning Disability Service at least one of the following is necessary for the referral to be accepted:

  • An unmet health need that the service can help with. There is an assessment of need and identification of needs that can be met by the community team.
  • That the person has a learning disability of a severity and extent that prevents them accessing mainstream health services with reasonable adjustments.
  • If a person has had input from a mainstream service previously that was not successful, the cause for this must be identified in order to understand the factors involved and clarify the needs of the individual.

If you would like any further information about the services provided by the Community Learning Disability Team, then please contact your local team who will be more than willing to assist you.

If you would like any further information in relation to GP Registers and Annual Health checks then please email us: HFinbox@lscft.nhs.uk.