Screening for diabetic retinopathy in adults with learning disability: current uptake and adjustments to facilitate equality of access

Abstract

Accessible summary People with learning disabilities who develop diabetes should be offered photograph tests of their eyes each year. People with learning disabilities who develop diabetes should have the same access to services as other people. This study looked at people with learning disabilities and diabetes to see whether they were getting the right tests for their eyes. In Bradford, most people with learning disabilities and diabetes have their eyes checked. Some people do not go to the appointment or find the tests difficult. A few people are not given an appointment at all. Changes should be made to help people with learning disabilities have their eyes checked, like allowing extra time and giving EasyRead information. SummaryEquality of access to health care for adults with learning disability has been in the spotlight in the UK in recent years due to publication of several reports. Adults with learning disability are thought to account for a significant proportion of the diabetic population in the UK. A list of adults known to the learning disability health facilitation team, Bradford, Yorkshire, UK, was crossed checked against the list of adults known to be eligible for diabetic retinopathy screening held by general practice groups. Various criteria were devised by which the quality of the service and equality of access could be measured. Overall 91% had been offered diabetic retinal screening; however, 35% of patients did not have a recorded screening outcome. Adults with learning disability and diabetes represent a very small proportion of the total local diabetic population. National audit standards require that 80% of patients with diabetes undergo retinopathy screening, and currently, this standard is not being met for adults with learning disability. There are many barriers to diabetic retinopathy screening for a patient with learning disability, and suggestions for ways to improve equality of access are discussed.