Screening programmes

Barriers to screening  

Adults with learning disabilities are often overlooked when it comes to health screening. Reasons for this include but are not limited to:

• Eligible patients may require extra support. For example, they may need help from carers with completing their bowel screening sample.
• Patients may have difficulty in navigating complicated appointment booking systems.
• Screening Hubs are not aware that a patient has a learning disability and will send out general information.
• The assumption may be made that women are not sexually active and will not require cervical screening.

There may be dependence on supported living workers to accompany eligible patients to their appointments.

Support available for screening

There is additional support for patients available including:

• Easy Read invitation letters (below) and information leaflets
• Short films explaining what to expect when going for screening
• Reasonable adjustments at appointments. For example, longer appointments can be organised with assistance from Learning Disability nurses at acute trusts.

The following Easy Read documents may be useful:

• Easy Read guide to cervical cancer vaccination
• Easy Read guide to breast screening 

How GP practices have got involved 

Practices have got involved by signing up to the Local Enhanced Service agreement and sending out easy read literature to those eligible patients who had not responded to their screening invitations. The results of the initial project are now available in our reports.

• Learning Disability Screening Project - Easy Read
• Learning Disability Screening Project - Executive Summary
• Learning Disability Screening Project - Full Report

Please continue to remind your patients to attend for screening using the template letters. The process can be found below. 

Process for practices

The image above shows the following steps: 

1. Sign up to the local Enhanced Service document
2. Complete a baseline audit
3. Send out easy read invitation letters to eligible patients who have not responded to their screening invitation
4. Send out additional easy read reminder if no response after six weeks
5. If there is still no response, call, text or send an additional reminder as per Accessible Information Standard
6. Complete a final audit and submit results
7. Practices will then receive reimbursement for taking part.

Need help with this process?

Email Rachel Johnson, Lead Strategic Health Facilitator: rachel.johnson10@nhs.net

Toolkit used for the Project:

1. Local Enhanced Service Sign up document.

2. Letter templates: Breast Screening, Cervical Screening, Bowel Screening.

3. Easy Read and Accessible information.

4. Best Interest Pathway and Form. 

5. Decision Making Pathway.

6. Form if unable to consent.

7. Reasonable adjustments.

8. Withdrawal letter.

9. Ceasing letter.

10. Useful contacts: Learning Disability Community Support Teams, Hospital Learning Disability Nurses.

11. Cancer Screening Pathways for patients with learning disabilities: Breast Chesterfield, Breast Derby, Cervical, Bowel.