Human rights are a series of moral principles or norms that describe certain standards of human behaviour. They are principally concerned with respect, fairness, equality, dignity and autonomy for all.  

The UK’s commitment to respecting and protecting human rights is rooted in the 1953 European Convention of Human Rights (ECHR). The UK Human Rights Act (1988) requires public bodies to act in ways compatible with the ECHR.

This means that public authorities, including providers of health care, must refrain from breaching human rights and take proactive steps to protect people from human rights abuses. 

Specific rights often mentioned, where people with a learning disability have a poor experience of health care services, typically relate to:

• the right to life
• the right to freedom from torture and inhuman or degrading treatment
• the right to liberty and security
• respect for private and family life
• protection from discrimination.

Despite international human rights declarations, conventions, treaties and domestic legislation, people with a learning disability often continue to have high levels of undetected and unmet health needs.

They may experience difficulties in accessing health care in the first place. If access is achieved, they may also receive a poorer service than other members of society. 

In 2009, the UK government signed the UN’s Convention on the Rights of Persons with Disabilities. This set out what is required to ensure disabled people’s rights are respected, protected and fulfilled.

Although not part of UK domestic law, it provides insight into how the rights enshrined in the Human Rights Act should be upheld for people with disabilities and makes clear that: ‘States should recognise that people with disabilities have the right to the highest attainable standard of health without discrimination on the basis of disability’.

People with learning disabilities should be able to access all health and care services and be treated equally. Health care professionals have a legal responsibility to provide support and reasonable adjustments to meet the needs of people with a learning disability.

Reasonable adjustments are a legal requirement under the Equality Act (2010) to make sure health services are accessible to all disabled people. They are adjustments that can make a big difference for people with learning disabilities when they attend health care appointments. 

A reasonable adjustment can be making appointments longer, offering appointments at the start or end of a clinic, providing a quiet area for someone to sit and wait, or seeing someone at home.

When reasonable adjustments are not possible, it is important that services have access to local learning disability services that can provide adapted or comprehensive interventions to promote access to the health care that people may need.

It is important to consider reasonable adjustments on an individual level and to find out what adjustments each person may need to promote equity of access and outcomes. The definition of “reasonable” is vague and services would need to evidence why an adjustment was “unreasonable” if they do not make the adjustments an individual needs.

Read the NHS Improvement publication The Learning Disability Improvement Standards for NHS Trusts (PDF) to read more about the standards that trusts are expected to meet to deliver high-quality services for people with learning disabilities, autism or both.

In 2024, the NHS rolled out the Reasonable Adjustment Digital Flag, making it a standard approach to care and treatment for all people with disabilities. Access free staff training to learn how the flag can be used to address some of the significant health inequalities experienced by people living with a disability or impairment. 

Useful resources

• Leeds and York Partnership NHS Foundation Trust. Learning Disability Service - Reasonable Adjustments (PDF).
• NHS England. Reasonable Adjustments. Information about reasonable adjustments and other information that will help you support patients with a learning disability.

The General Medical Council has produced a video that explores the patient experience of attending a hospital or general practice when they have a learning disability and why being healthy is important.  

You may also find the feedback below useful when it comes to understanding patient perspectives. These have been collected by Ace (Anglia)/ Peer Educators when talking to people with learning disabilities and/or ASD about the importance of attending annual health checks. 

Effective and ineffective health adjustments for people with learning disabilities and autistic people

What people told us helps them:

• “language I can understand”
• “Music in the waiting room would help me relax”
• “It helps to have someone with me to explain my medical history”
• “I’d like something to do while I wait”
• “Appointments at home”
• “I need things explained clearly”
• “They should make sure I have understood what is being said”
• “I would like pictures to tell me what I’m doing”
• “A book explaining what is going to happen to me, when I am waiting”
• “Its important that my doctor likes me and knows me”
• “I like to have someone hold my hand”
• “I like to be told what will happen after my tests”
• “My surgery uses a pager now that beeps when its your turn so you can wait somewhere else”“Better to have someone come into my appointments with me”
• “It helps to have questions I can understand, so I can understand it for myself”
• “Chairs that are not facing people in the waiting room”.

What people told us does not help them

• “There was equipment that was faulty or did not work”
• “I would like pictures to tell me what I’m doing”
• “The nurse was in a rush and missed my vein”
• “I’m not comfortable in large busy environments”
• “The receptionist on the phone didn’t know what an annual health check was she said it was a health review”
• “I’m petrified of needles because when I was younger the nurses and doctors held me down”
• “Doctors should listen to people with LD more and let them talk to them”
• “They took my favourite cuddly toy away”
• “The doctor sometimes doesn’t recognise I have a LD they should ‘check your notes’”
• “They were grumpy”
• “The toilet seat was too low in my surgery”
• “Too many signs and they are confusing”
• “Too many people in the surgery”
• “They spoke to my dad and not me”
• “Not enough time listening to mental health concerns or support there”
• “I don’t understand medication doses or measurements, I got in a muddle with the medication they gave me”
• “I was made to do wee sample and they didn’t have any grey trays that made me feel uncomfortable”
• “Can’t understand where to go if you can’t read”
• “The doctor talks about things I don’t know what they are talking about”.