Dr Pauline Heslop, Reader in Intellectual Disabilities Research, Norah Fry Research Centre
The National Institute for Health and Care Excellence (NICE) has recently been consulting on the scope of proposed guidelines on multimorbidity. Multimorbidity is, in summary, the co-occurrence of two or more chronic medical conditions in one person. Yet the proposed scope of the guidelines will not, in their current form, offer guidance on multimorbidity in people with learning disabilities. So is this a problem that needs attention? Yes.
The recent Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD) and other national and international studies suggest that people with learning disabilities have a greater number of health problems than others, and a greater variety of healthcare concerns than those of the same age and gender in the general population. This would suggest that particular attention must be paid to this population in any NICE Guidelines. Indeed, recommendation 3 of the CIPOLD report was that NICE Guidelines should take into account multimorbidity in relation to people with learning disabilities.
David Abbott, Professor of Social Policy, School for Policy Studies
How long are we ‘supposed’ to live for? ‘Three score and ten’ was a phrase I used to hear growing up (70 in new money). Our cultural ideas about life course and life span and who should die when are deeply ingrained. Parents should never bury their children, right? But what if you are born with or develop a condition which means that from a relatively young age your life span is destined to be much shorter than the norm and that without a dramatic medical breakthrough, very little will change that.
Boys (and it’s nearly always boys) diagnosed with Duchenne muscular dystrophy are one such group. Duchenne (or DMD) is an inherited neuromuscular disease and the average age of death used to be 19 but during the last few years, with significant improvements in the ways DMD is managed, has risen to around 27 years. There is currently no cure for DMD.
The challenges of providing a responsive GP service in the face of greater demand, a shortage of GPs and diminished available funding have been highlighted in the media over the past few months. Jeremy Hunt, the Health Secretary, has advocated for the greater use of telephone consultations to improve access to GPs by patients, but a new report published in the Lancet this week suggests that this does not reduce pressure on practices or save money, and may indeed increase workload. Yet some patient groups face greater barriers than others in accessing GP services. In recognition of this, the Royal College of General Practitioners (RCGP) has now selected autism as a clinical priority from April 2014-March 2017. The work, to be led by Bristol GP Dr Carole Buckley, will aim to improve access to primary care for people with autism and their families, and to enhance their health outcomes.
Food, Activity and Bodies (FAB) Kids is a school outreach project based on the importance of healthy lifestyles. It’s a free, fun and educational workshop aimed at encouraging children to think critically about their lifestyle choices (with regards to nutrition and physical activity in particular).
The project, led by Dr Mark Edwards, is being delivered by research staff in the University of Bristol’s Centre for Exercise, Nutrition and Health Sciences (ENHS). We do a lot of research into physical activity and nutrition, and much of this research is conducted in primary schools in Bristol and the surrounding counties. FAB Kids is our way of thanking the schools and children who take part in our research.
Telling acquaintances that you are part of a team reviewing the deaths of people with learning disabilities can stop a conversation in its tracks. Most people glaze over, make excuses and beat a hasty retreat. So how could we encourage the Government to listen to, and commit to addressing the issues?
The Confidential Inquiry into premature deaths of people with learning disabilities (CI) was commissioned by the Department of Health as a three-year project to assess the extent of premature deaths in people with learning disabilities and offer guidance on prevention. In March 2013 we reported our findings to the Department of Health and shared them nationally through a series of media interviews, public conferences and events. We also engaged with Parliament in a number of ways – including giving evidence at a House of Lords Select Committee, addressing an All Party Parliamentary Group meeting, and briefing peers for a debate in the House of Lords.
Last month’s government-commissioned school food review showed that the nutritional quality of school food has improved substantially since 2005, when Jamie Oliver started its campaign to improve the nutritional value of school meals. Nevertheless, take-up of school meals remains low, at 43%. In other words, 57% of children are not eating school lunches, but bring a packed lunch, have snacks, or buy their food elsewhere. The report shows that the majority of these meals are unhealthy. In fact, in contrast to what most parents think, only 1% of packed lunches meet the nutritional standards.
In addition to affecting child health, there is substantial evidence that poor nutrition affects cognitive performance. Michèle Belot and Jonathan James show in their study that the Jamie Oliver campaign led to a significant increase in children’s test scores in primary schools (Key Stage 2), as well as a drop in authorised absences (i.e. those that are mostly linked to illness and health).