Executive summary for professionals - 2nd edition

Definition of Specialist Learning Disability Physiotherapists: 

"Learning disability physiotherapists provide specialist assessment, treatment and management to adults with a learning disability whose needs cannot be successfully met by mainstream services, even when reasonable adjustments are  made. Physiotherapists will work in collaboration with the person, their network of care, mainstream health services, and the multidisciplinary team to enhance, optimise and maintain the person’s physical presentation, function and quality of life."

Adults with a learning disability experience significantly poorer health outcomes than the general population. They have a shorter life expectancy, are more likely to experience multiple long-term health conditions and remain at increased risk of avoidable and premature mortality. Despite having the same legal entitlement to access mainstream healthcare, adults with a learning disability continue to experience inequitable access to services and poorer experiences and outcomes. Health and social care providers have a statutory duty to make reasonable adjustments to ensure equitable access to care. Whilst many adults with a learning disability can successfully access mainstream physiotherapy through the provision of reasonable adjustments, some individuals have complex needs that require specialist learning disability physiotherapy services.

Specialist learning disability physiotherapists provide assessment, treatment and management for adults whose physiotherapy needs cannot be met within mainstream services alone. They are an integral part of Community Learning Disability Teams and work collaboratively with individuals, families, carers, mainstream healthcare providers and multidisciplinary colleagues to optimise physical health, function, participation and quality of life. In addition to providing direct clinical intervention, specialist learning disability physiotherapists support mainstream services through consultation, education and service development, improving equitable access to physiotherapy and wider healthcare.

The Standards of Practice for Physiotherapists Working with Adults with a Learning Disability (Second Edition) provide a contemporary framework for specialist practice across the United Kingdom. They have been systematically developed through consideration of the available evidence alongside expert professional consensus and reflect developments in clinical practice, research, health policy and service delivery since the publication of the first edition. The Standards recognise the changing health needs of adults with a learning disability, including increasing life expectancy, the management of long-term conditions, healthy ageing, frailty and the continued emphasis on prevention, personalised care and community-based services.

The Standards aim to:

• support specialist learning disability physiotherapists to deliver safe, effective, evidence-informed and person-centred care;
• promote consistency in specialist physiotherapy practice across the United Kingdom;
• strengthen clinical reasoning, professional decision-making and service quality;
• support commissioners, service managers and system leaders in the planning, commissioning and evaluation of specialist physiotherapy services;
• increase awareness and understanding of the role and contribution of specialist learning disability physiotherapists across health and social care; and
• provide services with a framework for implementation, quality improvement and workforce development.

Specialist learning disability physiotherapy contributes to improved physical health, functional ability, participation, quality of life and experiences of care for adults with a learning disability. By preventing avoidable deterioration, supporting access to appropriate healthcare and promoting independence, specialist physiotherapy also contributes to reducing health inequalities and delivering more effective and sustainable health and social care services. These Standards provide a national benchmark for specialist practice and support the continued development, recognition and commissioning of specialist learning disability physiotherapy services across the United Kingdom.

David Standley
Clinical Specialist Physiotherapist and Chair of the ACPPLD

Sarah Bruce
Consultant