Decisions about care placements are made locally, based on individual assessments of need and personal circumstances. Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets and commission services to meet the diverse needs of all local people. This includes commissioning a variety of different providers and specialist services that provide genuine choice to meet the needs of local people, and that offer quality and value for money.

There is no single national assessment of the impact of out‑of‑area placements on disabled adults and their families. However, local authorities should engage with people who draw on care and support, and their families and carers, to inform commissioning decisions and to consider the outcomes which matter to them. This is reflected in the Care and Support Statutory Guidance, which supports local authorities to fulfil their Care Act duties, including expectations around involvement and co‑production with people who draw on care and support and their families.

Decisions about care placements are made locally, based on individual assessments of need and personal circumstances. Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets and commission services to meet the diverse needs of all local people. This includes commissioning a variety of different providers and specialist services that provide genuine choice to meet the needs of local people, and that offer quality and value for money.

There is no single national assessment of the impact of out‑of‑area placements on disabled adults and their families. However, local authorities should engage with people who draw on care and support, and their families and carers, to inform commissioning decisions and to consider the outcomes which matter to them. This is reflected in the Care and Support Statutory Guidance, which supports local authorities to fulfil their Care Act duties, including expectations around involvement and co‑production with people who draw on care and support and their families.

The Department does not collect data specifically on the number of adults with learning disabilities who are placed outside their local authority area. However, national statistics on adults with learning disabilities receiving long-term support are published annually in the Adult Social Care Activity Report.

Where out-of-area placements are made, local authorities have a duty under the Care Act 2014 to ensure that, among other things, decisions are based on a consideration of each individual's needs and preferences.

When a local authority has reasonable cause to suspect an adult in the local authority’s area has care and support needs, is at risk of, or experiencing abuse or neglect, and cannot protect themselves because of those needs, it must carry out a safeguarding enquiry.

Local authorities must work with their partners under section 6(7) of the Care Act 2014, and those partners must also work with the authority to carry out their care, support, and adult protection duties.

Our 10-Year Health Plan sets out to tackle health inequalities and offer people with disabilities more holistic, on-going support in the community.

Action is underway to improve access and support for people with a learning disability through mandatory training for health and care staff, continued uptake of annual health checks and health action plans, and the Mental Health Act reforms.

When a local authority has reasonable cause to suspect an adult in the local authority’s area has care and support needs, is at risk of, or experiencing abuse or neglect, and cannot protect themselves because of those needs, it must carry out a safeguarding enquiry.

Local authorities must work with their partners under section 6(7) of the Care Act 2014, and those partners must also work with the authority to carry out their care, support, and adult protection duties.

Our 10-Year Health Plan sets out to tackle health inequalities and offer people with disabilities more holistic, on-going support in the community.

Action is underway to improve access and support for people with a learning disability through mandatory training for health and care staff, continued uptake of annual health checks and health action plans, and the Mental Health Act reforms.

Decisions about care placements are made locally, based on individual assessments of need and personal circumstances. Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets and commission services to meet the diverse needs of all local people. This includes commissioning a variety of different providers and specialist services that provide genuine choice to meet the needs of local people, and that offer quality and value for money.

There is no single national assessment of the impact of out‑of‑area placements on disabled adults and their families. However, local authorities should engage with people who draw on care and support, and their families and carers, to inform commissioning decisions and to consider the outcomes which matter to them. This is reflected in the Care and Support Statutory Guidance, which supports local authorities to fulfil their Care Act duties, including expectations around involvement and co‑production with people who draw on care and support and their families.

The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 require local authorities that provide adult social care services to have complaints procedures that follow a certain process. They should work with the person raising the complaint to try and resolve it.

If someone is not satisfied with the outcome of their complaint to the local authority, then the Local Government and Social Care Ombudsman (LGSCO) can investigate individual concerns. The LGSCO is the independent complaints lead for adult social care and investigates complaints from those receiving social care. Details of how to complain to the LGSCO can be found at the following link:

https://www.lgo.org.uk/make-a-complaint

There is also a help and advice line available via telephone on 0300 061 0614, or one can write to The Local Government Ombudsman, PO Box 4771, Coventry, CV4 0EH.

Whilst adults with a learning disability do not automatically qualify for free National Health Service sight tests, they may qualify under other categories of exemption, for example being in receipt of income-related benefits or through the NHS low-income scheme.

To support children and young people with learning disabilities, free NHS sight tests are available within special educational settings across England, that choose to host a service.

The Department does not hold data relating to what proportion of adults with a learning disability in England have a regular annual health check with a general practitioner.

NHS England is required to offer to all primary medical services contractors the opportunity to enter into arrangements under the Network Contract Directed Enhanced Services (DES) Scheme. Integrated care boards (ICBs), as commissioners of primary care services, are responsible for ensuring that there is sufficient provision of these services to meet the needs of their patient population.

As part of the Network Contract DES Learning Disabilities Health Check Scheme, primary services contractors are required to identify registered patients aged 14 years old or over who have learning disabilities and to record this on a learning disabilities register. Contractors are required to offer annual health checks to these patients.

In the statutory guidance of the Care Act 2014, it states that local authorities must ensure that the services they commission are safe, effective, and of high quality.

Each integrated care board must have an executive lead for learning disability and autism who will support the board in addressing health inequalities, thereby supporting equal access to care across all health services and improving overall health outcomes.

Under the Health and Care Act 2022, Care Quality Commission registered providers are required to ensure their staff receive specific training on learning disability and autism appropriate to their role, to provide safe and informed care.

A Reasonable Adjustment Digital Flag is being rolled out across health and care services to ensure that disabled people’s reasonable adjustments are recorded and shared, to enable tailoring of appropriate support. This is aided by e-learning for health and social care staff.

All optometrists are expected to be aware of, and comply with, the General Optical Councils standards of practice, which requires optometrists and dispensing opticians to communicate with patients in a way that they can understand. Guidance issued by the College of Optometrists also sets out that when examining patients with learning difficulties, optometrists should use tests that are appropriate to the patient’s needs.

NHS England is also rolling out a Reasonable Adjustment Digital Flag which supports health and care staff to tailor care in line with the specific reasonable adjustment a person needs, including any needs in relation to their learning difficulty. The flag allows health and care staff to easily see and share the adjustments needed for that person to access services equally, such as longer appointments, easier-to-read communication, or different booking methods. This is in addition to the requirement for all National Health Service organisations to comply with the Accessible Information Standard and ensure that people with a disability, impairment, or sensory loss can access information they can easily read and understand.

Under the Government’s 10-Year Health Plan, carers will be actively involved in the care planning of those they care for, mirroring the practices of family group conferencing.

Additionally, we are increasing the information captured about unpaid carers throughout the health and care system to help us better understand responsibilities and provide more targeted support. Development of a new ‘MyCarer’ section of the NHS App will also allow people to communicate more easily with relevant clinical team members on behalf of those for whom they care.

To provide further support, in April, the Government increased the Carer’s Allowance weekly earnings limit from £151 a week to £196, the largest ever increase since the Carer’s Allowance was introduced in 1976.

On 19 June 2025, the Department laid a Code of Practice in Parliament which sets out how providers can meet the statutory requirement for learning disability and autism training.

Over three million people have completed the e-learning package, the first part of the Oliver McGowan Mandatory Training on Learning Disability and Autism (Oliver’s Training). National Health Service providers have reported that approximately 520,000 people have completed either Tier 1 or Tier 2 of Oliver’s Training. At the end of August 2025, 2,850 people have been trained to deliver Oliver’s Training and have been added to the Approved Trainer list.

Data on completion of Oliver’s Training by the NHS is held locally and is reported to NHS England by the integrated care boards. This data does not differentiate between completion by frontline staff and other NHS and social care staff and is instead focussed on the overall completion of Tier 1 and Tier 2.

The Department will be providing funding in autumn 2025 to support rollout of Oliver’s Training to the adult social care sector, via the same online claims service as the Learning and Development Support Scheme.

NHS England advises that there is not a strong evidence base for the benefits of hydrotherapy for people with learning disabilities. As part of their duties under the Care Act 2014, local authorities are expected to ensure high quality services that put the wellbeing of people who draw on care at the centre of decisions and ensure positive outcomes. It is the role of local authorities to facilitate the personalisation of care and support services and encourage a variety of services for their population, such as community support options.

As set out in NHS England’s Planning Guidance, integrated care boards (ICBs) are expected to work with local system colleagues to ensure that there is high quality and accessible community infrastructure in place for people with a learning disability and autistic people. The guidance is available at the following link:

https://www.england.nhs.uk/publication/2025-26-priorities-and-operational-planning-guidance/

ICBs are expected to assign an executive lead role for learning disability and autism to support planning to meet the needs of people with a learning disability and autistic people.

The Learning from Lives and Deaths reports are a crucial source of evidence which help to identify the key improvements needed to tackle health disparities and prevent the avoidable deaths of people with a learning disability and autistic people. We are committed to publishing the latest report soon after Parliament returns, alongside a Written Ministerial Statement.

Data on completion of the Oliver McGowan Mandatory Training on Learning Disability and Autism (Oliver’s Training) is held locally and is reported to NHS England by integrated care boards. This data does not differentiate between completion by frontline staff and other National Health Service and social care staff, and is instead focussed on overall completion of Tier 1 and Tier 2. Tier 1 of Oliver’s Training is for those that require general awareness for their role, and Tier 2 is for those who may provide direct care for people with a learning disability and autistic people. The first part of both tiers of training is a co-produced e-learning module which has had over three million completions across all audiences. The most recently validated data on completion of both parts held by NHS England is up to March 2025, when it was reported that 85,718 staff had completed Tier 1 training and 113,003 had completed Tier 2 training.

NHS England is supporting the roll out of the training on a Payment by Results basis, co-coordinated by integrated care boards, and continues to monitor training uptake.

Our 10-Year Health Plan will transform the National Health Service, shifting care from analogue to digital. We know that patients, including those with a learning disability, often have to tell their story at every appointment. The single patient record means that they will only need to tell it once. The record will improve secure access for patients and clinicians and ensure seamless treatment across the NHS. This will connect a patient’s health history in one secure place, accessible through the NHS App. Patients will get a legal right to access their single patient record by default and will be able to check their own information and alert clinicians where there are errors.

In addition, the Reasonable Adjustment Digital Flag was developed to enable health and care workers to record, share, and view details of reasonable adjustments, across the NHS and social care, wherever the person is seen or treated.

On 30 June 2025, a revised Accessible Information Standard was published. It describes how NHS and adult social care services should identify, record, flag, share, meet, and review people’s information and communication support needs. The revised Accessible Information Standard is available at the following link:

https://www.england.nhs.uk/accessible-information-standard/

In 2024, NHS England also published guidance on health and care passports, which are designed to be a quick and easy way to give health and social care professionals more information about people with a learning disability and other disabled people so that they can provide the right care and treatment. The guidance on health and care passports is available at the following link:

https://www.england.nhs.uk/publication/health-and-care-passports/

The Government wants to better support disabled people, including those with a learning disability, to participate in society and access high quality care and support. Our 10-Year Health Plan sets out the actions we are taking to move care from hospitals to communities and prevent sickness rather than treat it. These reforms will support improved life outcomes for people with a learning disability through more holistic, personalised support. Specific action is also being taken to roll out mandatory training on learning disability for health and social care staff.

My rt. Hon. Friend, the Secretary of State for Health and Social Care, has not had specific discussions with the integrated care board (ICB) as described. NHS England typically direct relationships with ICBs.

NHS Dorset has a Learning Disabilities budget of £99.18 million for 2025/2026. This budget covers the community services commissioned through their core contracts, non-contract activity, continuing healthcare commitments, support for individual patients, advocacy and support services, and some service development initiatives including the full implementation of a keyworker service.

In addition, each ICB must have an executive lead for learning disability whose role includes: supporting the board in addressing health inequalities; supporting equal access to care across all health services; and improving overall health outcomes.