Wigan Borough Clinical Commissioning Group is the statutory body responsible for commissioning local health services in Ashton, Leigh and Wigan.

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NHS Wigan Borough Clinical Commissioning Group and NHS Bridgewater Community Healthcare NHS Foundation Trust service helps people with learning disabilities

An initiative to help people with learning disabilities to access and navigate local health services is now helping people, their families and their carers.

NHS Wigan Borough Clinical Commissioning Group commissioned  NHS Bridgewater Community Healthcare NHS Foundation Trust to provide a Specialised Services Primary Care Access Team to work with GP practices to help them identify patients who may have learning disabilities and make sure they are getting the health care they need.

Dr Tim Dalton, local GP and Chair of NHS Wigan Borough Clinical Commissioning Group said:

“People with learning disabilities often have poorer health and can find it difficult to access and navigate local health services. We commissioned NHS Bridgewater Community Healthcare NHS Foundation Trust to provide a specialised service to make sure that people with learning disabilities are getting the health care they need”.

The team has developed a ‘Did Not Attend (DNA) Care Pathway’ following concerns raised by GPs that patients with learning disability do not routinely attend their annual health checks and cannot always be contacted by GP staff.  Following referral from their GP the team visit the patient at home to assess if they are making an informed choice in not accessing health care. The Primary Care Access Team also identify if there are any barriers that prevent people with a learning disability from getting the health care they need and adjustments can then be made such as the GP Practice sending easy read letters; providing appointment reminders by phone and ensuring that clinic locations are close to home. There is, of course, the option for patients to opt out of receiving this care if they wish.

To help stop young people falling out of the care system when they become adults, the team help children in the education system with statements of learning disability and make sure they are being invited for a health check on leaving education. Additionally GP Practice staff are offered learning disability awareness training; help with developing their awareness of the Mental Capacity Act and how to support patients with learning disabilities to make informed decisions about their care.


Case Study:

This patient story was presented to the Bridgewater Board in November 2014 and focused on Mr H and his referral to the Adult Learning Disabilities Team in 2014 via the DNA (did not attend) Pathway.

 Mr H did not attend his GP for approximately three years when he moved home as it was too far and too costly to travel to the GP he was registered with. Mr H was not aware of the healthcare options available to him, including the option to move GPs. Mr H received many letters from his GP which he could not understand and therefore didn’t respond to. There were no attempts made at this stage to help Mr H engage with health care services and he had effectively fallen out of the system. The DNA pathway had been introduced in Wigan to identify patients such as Mr H by working with Practices.

Once the Learning Disabilities Team had identified that Mr H had been disengaged from services, they contacted him and as a result were able to assist Mr H with registering with a new local GP, having a full health check, activating Social Services Support attending physiotherapy appointments to help with falls he was having and managing diabetes including meal planning. Mr H is now able to make more informed choices about his healthcare.


The service has also implemented measures to help practices engage better with patients such as Mr H including easy read correspondence and patient information leaflets. There were still some issues in terms of reasonable adjustments being made within health services for patients with Learning Disabilities in everyday practice and this was being worked on. Mr H advised that he felt much better as a result of the service’s help.

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