PurposeThe purpose of this paper is to introduce and present the first findings of a new English performance indicator in the primary healthcare of adults with Down syndrome. This is a performance target, with associated bonus payment, requiring General Practitioners (GPs) to undertake annually a screening blood test for thyroid hormone deficiency.Design/methodology/approachAnalysis and review of data collected from all GP practices and published by the National Health Service (NHS) Information Centre.FindingsIn total, 82 per cent of those identified as in the target group were screened and 10 per cent were identified as not wanting to be screened or screening inappropriate. The target group numbered just over 60 per cent of the number estimated from epidemiological and other studies. The numbers of cases involved is small (0, 1 or 2 cases in 75 per cent of GP practices), and whilst variation in coverage at local level appears important, numbers are too small for the variations seen in the first year's data to be statistically significant. The scope of the data precludes useful strategic analysis of the value of the intervention.Research limitations/implicationsData from several years need to be taken together. The NHS Information Centre should slightly increase the scope of the data to allow analysis of whether the programme is having useful public health benefits.Originality/valueThe paper examines a new data source and makes points applicable to a wider range of similar datasets in the same programme.

PurposeThe purpose of this paper is to provide a commentary on Alix Lewer's and Celia Harding's research on the factors influencing the success of speech and language therapy intervention in residential homes and day centres for people with learning disabilities.Design/methodology/approachThe article reflects on the issues raised by Lewer and Harding, in the light of the literature on implementation and the author's own research on the implementation of behaviour support plans.FindingsSimilar barriers underlie problems of implementation of programmes related to communication and behaviour support.Originality/valueProfessionals need to improve their understanding of implementation problems and ensure that their role includes providing support to frontline staff to initiate and maintain changed practices.

PurposeThe purpose of this paper is to report on trends in the provision of health checks for adults with learning disabilities over the period 2008/9‐2011/12.Design/methodology/approachAnalysis of data collected by the Information Centre for Health and Social Care from Primary Care Trusts in England.FindingsOver the four years the percentage of eligible adults receiving a health check has consistently increased and now stands at 53 percent. There remain marked variations across both Strategic Health Authority areas and Primary Care Trusts.Research limitations/implicationsThere remains considerable distance to travel before minimum standards of satisfactory performance in the provision of health checks are achieved nationally. It is important to consider possible obstacles to provision and how these can be addressed to improve uptake further.Originality/valueThe paper examines consistency of good and poor performance by local areas over time. It is clear that significant improvements are required in a number of strategic health authority and primary care trust areas if minimum standards are to be met.

PurposeThe aim of this paper is to comment on Broadhurst et al.'s evaluation of the My Way transition programme.Design/methodology/approachReflects on Broadhurst et al.'s account in the context of recent and current transition initiatives within the UK.FindingsTransition support remains a problematic area. Successful support needs to include a number of elements.Originality/valueThere is a clear role for the kind of facilitation used in the My Way project as a means of providing creative support to young people and their families.

PurposeThis paper seeks to provide a commentary on the previous paper in this issue, “Love is simply not enough”.Design/methodology/approachThe commentary draws on research findings and recent policy about personalisation to consider those factors influencing the development of effective family and professional partnerships.FindingsThe paper notes the way in which families have often been undermined by those authorities responsible for providing support. While a lifelong caring role will be a positive choice for some families, it should not be a requirement.Originality/valueThe commentary draws attention, in particular, to the importance of local authorities working more effectively with family carers.

PurposeThe purpose of this paper is to summarise what is known about the health of people with autism spectrum disorder (ASD).Design/methodology/approachThe paper aims to update the unpublished review and scoping paper undertaken by Swift for the Foundation for People with Learning Disabilities; provide a conceptual framework for understanding the key determinants of the poorer health outcomes experienced by people with ASD; undertake a brief option appraisal of existing sources of data that may be of value in addressing the mortality and morbidity of people with ASD; and establish future research possibilities.FindingsThe limited literature suggests higher rates of mortality and morbidity among people with ASD.Originality/valueA simple conceptual framework for understanding the key determinants of poorer health of people with ASD is proposed. Options for studying the mortality and morbidity in ASD using existing data sources are also appraised and recommendations are made for future research in the area.

This article focuses on people with complex needs and the impact of Valuing People and Valuing People Now on improving their lives and opportunities. It considers the current situation and challenges, where most people with complex needs have experienced disadvantage and have not seen as much improvement in opportunities as others. Health needs are covered elsewhere in this journal, and so this article looks at the remaining priorities in Valuing People Now: housing and employment. The key issues are explored and the Sustainable Hub for Innovative Employment for People with Complex Needs, established as a result of the Valuing People Now employment work, is described. It explores the lessons learnt so far and the challenges faced, with a summary of the next steps.

It is widely known that a relatively small number of very expensive, often out‐of‐area, placements consume a relatively large proportion of the social care budget. Valuing People Now (DH, 2009) acknowledged that too often people are sent to expensive out‐of‐area placements. There is, however, little research in this area and no routinely collected information. In this collaborative piece of work between the Valuing People Now Team, the Challenging Behaviour National Strategy Group and the Tizard Centre we aimed to identify the characteristics of the highest‐cost placements in the South‐East of England.