6591 Supporting access to primary care health monitoring in children with ‘Learning Disability’ – an audit of diagnosis terminology

Objectives The process of diagnosing learning disability varies and there is currently no statutory body commissioned to do so. Primary care can assign patients to a 'Learning Disability' register if a child has been diagnosed with a learning disability or has a medical diagnosis that 'indicate' or 'may indicate' learning disability.¹ Children aged over fourteen years with a diagnosis of 'Learning Disability' are eligible for an annual health check in primary care.² Individuals with a learning disability are at increased risk of physical and mental health complications with increased risk of early mortality meaning such monitoring is crucial. This audit aimed to assess the proportion of children currently diagnosed with 'Learning Disability' in Community Paediatrics and to consider how paediatricians can improve diagnostic terminology and process. Methods 42 children were selected randomly by the Trust clinical audit team from the Community Paediatric caseload. Cases were selected from January 2022 to March 2023 and included children aged fourteen and older. Data was extracted from SystmOne including whether children were assigned an alert for 'Learning Disability' or 'SEND.' Diagnoses were collected from most recent Community Paediatric clinic letter or if not available, scanned notes. Descriptive statistical analysis was conducted and diagnoses cross-referenced with the 'Learning Disability' register to consider if a child may be eligible for a diagnosis of 'Learning Disability.' Results 21 children (50%) had a diagnosis indicating or that may indicate 'Learning Disability.' Of children who could be assigned a diagnosis of 'Learning Disability,' two children (9.5%) had a diagnosis of 'Learning Disability' listed in their clinic letter. The same two patients had a 'Learning Disability' alert on SystmOne (100%). Seven children (33%) had a SystmOne 'Learning Disability' alert where their diagnosis indicates or may indicate a learning disability. Two children had a 'Learning Disability' alert on SystmOne without a diagnosis that correlated with a diagnosis of 'Learning Disability.' Conclusion Findings of the audit highlight reduced awareness of medical conditions that may predispose to learning disability. A lack of diagnosis means there is missed opportunity for such children to access health checks in primary care. Moreover, children's experience of hospital could be improved if awareness of their learning disability needs is highlighted. All clinicians should therefore consider if their patients meet criteria for diagnosis of Learning Disability and support them in accessing healthcare resources to improve their physical and mental wellbeing. References NHS England and NHS Improvement. Improving identification of people with a learning disability: guidance for general practice [Internet]. NHS England and NHS Improvement. [cited 2023 October 30]. Available from: https://www.england.nhs.uk/wp-content/uploads/2019/10/improving-identification-of-people-with-a-learning- disability-guidance-for-general-practice.pdf NHS. The NHS Long Term Plan. [Internet]. NHS. [cited 2023 October 30]. Available from: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/nhs-long-term-plan-june-2019.pdf.