Learning Disabilities

A learning disability is a reduced intellectual ability which is usually diagnosed soon after birth or in the early years and is a lifelong disability. Many people with a learning disability may find some everyday activities challenging, for example household tasks, socialising or managing money. Other people with a learning disability may need to be fully supported in all areas of their life, including communicating, personal care, and staying safe. People with a learning disability are likely to take longer to learn and need support to develop new skills, understand information or maintain relationships.  

Although a learning disability is lifelong, many people can develop and sustain new skills throughout their lives; and, of course, societies and communities can change to be more inclusive ensuring reasonable adjustments are in place. With the right support and an inclusive community, people with a learning disability thrive and live meaningful and fulfilling lives. 

There are approximately 1.5 million people with a learning disability in the UK, representing 2.16% of adults and 2.5% of children. Approximately 1.3 million of those people with a learning disability are in England. (Source: Mencap) 

Most people live their lives without support from specialist learning disability services. For example, of the 1 million adults with a learning disability, approximately 128,000 working-age adults and 22,000 older adults (aged 65+) with a learning disability received long-term support in England in 2023/24 (Source: Mencap). 

A small number of people with a learning disability may have more profound needs, and at the end of December 2025 there were 2,030 people with a learning disability and those who are autistic in inpatient mental health services. 50 percent of those in inpatient services had been in hospital for over 2 years. (Source: NHS England) 

• The Care Act 2014.
• Under the Equality Act 2010, organisations have a legal duty to make changes in their approach or provision to ensure that services are as accessible to people with disabilities as they are for everybody else. Reasonable adjustments for people with a learning disability.
• The Children and Families Act 2014 aims to improve services for children and young people with special educational needs and disabilities (SEND), ensuring coordinated education, health, and care support. 
• The Health and Care Act 2022 requires health and social care workers to receive autism and learning disability training through the Oliver McGowan Mandatory Training. This helps ensure care is safe, compassionate, and informed.  
• Building the Right Support (Transforming Care Programme).
• LeDeR Policy.
• NICE – People with learning disabilities – this resource provides a link to 6 relevant NICE guidelines relating to the health and care of people with learning disabilities, including challenging behaviour, older people, mental health, and care and support needs.   
• NHS 10 Year Health Plan for England.
• National Disability Strategy – these laws, statutory duties and policies commit us to better understanding and supporting people with learning disabilities to live full lives and enhance quality of life. This includes working closely across the health, education, community and social care system to enhance support for children, young people and their carers. 

Estimates of the number of adults with a learning disability are available from Projecting Adult Needs and Service Information (PANSI). These estimates are based upon research conducted in the early 2000s, calculating age-specific rates which can be applied to ONS population projections. The estimated number of adults with a moderate or severe learning disability in Lincolnshire was 3,589 in 2025, which is projected to rise to 3,999 by 2045. 

In addition to PANSI estimates, we can also improve understanding of our learning disability population through the Learning Disability Register maintained in Primary Care. In Lincolnshire, there are around 5,000 people on this register (approximately 0.6% of the population). Of those who are registered, around 75% are in receipt of an annual LD Health Check, meeting the national NHS England target. (Source: Lincolnshire Learning Disability Register).  

In 2025, around 2,000 adults were supported by the Adult Care Learning Disabilities Teams in Lincolnshire. Of these around 450 people were living in residential care and the rest were living in their own home, including with family and supported living. (Source: Learning from Lives and Deaths Review (LeDeR). Regional and national benchmarking shows use of residential care for 18-64-year-olds in Lincolnshire is comparatively high. (ASCOF Data).  

Health inequalities 

People with a learning disability experience health inequality to a greater extent compared to those without a learning disability. This can be seen in a range of health conditions and risk factors compared to the population without a learning disability. 

Nationally, the percentage of ‘avoidable deaths’ — where death occurs in someone under the age of 75 to a condition deemed preventable, treatable, or both — has fallen from 46% in 2021 to 39% in 2023. Whilst an improvement, the rate is almost double that of avoidable deaths in the general population (21%).  

People with a learning disability are more likely to experience mental health issues, are at higher risk of engaging in less healthy behaviours, are more likely to live with physical issues and are less likely to get vaccinated or go to health screenings. Learning from Lives and Deaths Review (LeDeR) – Lincolnshire ICB

People with a learning disability and autistic people often have poorer physical and mental health than other people and may face barriers to accessing health and care to keep them healthy and maintain a good quality of life. Too many people with a learning disability and autistic people are dying earlier than they should, many from things which could have been prevented, detected early or treated. (Source: NHS England)  

Research has shown that many avoidable deaths among people with a learning disability are linked to poor-quality healthcare, rather than a lack of preventative interventions. Contributing factors include delays in diagnosis, failure to make reasonable adjustments, not recognising patients as having a learning disability, and the misapplication of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR). (Source: UK Parliament) 

Diagnostic overshadowing is also a concern. This occurs when healthcare professionals mistakenly attribute a person’s symptoms or behaviours solely to their learning disability or autism, without investigating other potential physical or mental health issues. As a result, serious conditions (such as cancer) may go undiagnosed (Source: University of Hertfordshire). 

In 2025, the median age of death for people with a learning disability or autistic people was 55 years. The average life expectancy for the Lincolnshire general population is 81 years. The top three causes of death were aspiration pneumonia (a respiratory infection that affects the lungs), cancer and sepsis. This is slightly different to 2024 where cardiovascular disease was third highest.   

For more information, priority actions and next steps, please see the latest report on Learning from Lives and Deaths Review (LeDeR) – Lincolnshire ICB.

Living arrangements 

The need for accommodation for people with a learning disability in Lincolnshire is expected to see a gradual increase over time driven by young people with Special Educational Needs and Disabilities moving into adulthood, rising working-age adult demand, increasing complexity, and wider socioeconomic pressures. Ensuring that sufficient appropriate accommodation options are available is important to supporting independence, preventing people moving in a crisis, often to more institutional, out of area and costly services, and enabling people with a learning disability to live ordinary lives within their local communities. 

Since 2020, Lincolnshire has seen a 54 per cent increase in Education, Health and Care Plans, with the 20–25 age group increasing by 54.9%, indicating a growing cohort of young people moving into adulthood, some of whom will have a learning disability. This group is likely to increase the need for supported accommodation that promotes independence and provides appropriate levels of care and support, particularly in districts such as Boston and East Lindsey, where EHCP growth has been most pronounced. (Source: Lincolnshire County Council Performance Data).

Complexity of need among working-age adults is also increasing, with 24.8% adults living with two to four long-term conditions and 1.7% experiencing high levels of complexity. Complexity refers to the combination of medical and nonmedical factors that interact to make a person’s health needs more difficult to manage. For people with a learning disability, this is likely to present as a need for accommodation that can support people with additional health needs, mental health needs, autism or behaviours of concern, that can challenge traditional services and require a more personalised approach. (Source: Lincolnshire County Council) 

Behaviours that can challenge traditional services 

“Behaviours that can challenge” are behaviours “of such an intensity, frequency or duration as to threaten the quality of life and/or the physical safety of the individual or others and is likely to lead to responses that are restrictive, aversive or result in exclusion”. We understand these as behaviours, as a means of a person communicating something to others. Between 10-15 per cent of people with a learning disability communicate their distress through behaviours, in education, health or social care settings, often peaking between the ages of 20-49 (Source: Pilling et al., 2016). 

Behaviours of concern always happen for a reason and may be the person’s only way of communicating an unmet need. Behaviour—including aggression, self‑injury, withdrawal, or repetitive actions—often serves as a person’s best available method of communicating unmet needs when other methods fail. Information about communicating with people with a learning disability is widely available online (Source: The Challenging Behaviour Foundation). Approaches that move towards relational based approaches and those that consider the system and environment, move away from blaming the person including trauma informed care and Positive Behaviour Support (PBS) are examples of approaches to consider when working with people with a learning disability. PBS is based on working with the individual and their support network to understand why someone is distressed, the impact their environment has on them and the best ways to keep them safe and happy. PBS has received criticism due to a focus on behaviour rather than emotions and relationships and association with attempting to suppress behaviours that are natural and beneficial to people with a learning disability and autistic people, that may not be deemed as socially acceptable. PBS should always be person centred and consider the needs of the individual from the perspective of the individual. (Source: The Challenging Behaviour Foundation) 

Employment 

The evidence that appropriate and meaningful work can bring health and wellbeing benefits is widely recognised. However, employment rates amongst disabled people reveal one of the most significant inequalities in the UK (Source: Department for Work and Pensions et al). Mencap’s 2025 Big Public Transport Survey found 29% of working age adults (aged 18 to 64) with a learning disability have a paid job. This is compared to: 

• 53% of working age adults with any disability, and 
• 75% of working age adults (aged 16-64) in the general population in the UK. 

Employment rates for people with a learning disability and/or autism have remained low for many years. The associated NHS Digital Adult Social Care Outcomes Framework (ASCOF) indicator 1E measures employment outcomes for adults with a primary support reason of learning disability support, and shows Lincolnshire rates as slightly lower than the national average.

Multi-agency collaboration to improve outcomes for people with a learning disability is led by the Mental Health, Dementia, Learning Disability and Autism (MHDLDA) Alliance in Lincolnshire. The MHDLDA has a broad membership that includes Lincolnshire Partnership Foundation Trust (LPFT), Lincolnshire County Council (LCC), Lincolnshire Integrated Care Board (ICB), representatives from the Voluntary and Community Sector, District Councils, the Office of the Police and Crime Commissioner and people with lived experience. The MHDLDA Alliance are working collaboratively to deliver the following strategic priorities: 

• Prevention and early intervention 
• Maximising independence 
• Improving quality and experience 
• Reducing inequalities in access, experience and outcomes 
• Improving on outcomes that matter to people  

In Lincolnshire, we are committed to identifying and learning more about deaths (avoidable and otherwise) of people with a learning disability through the LeDeR programme. To address health inequalities, we need to continue to: 

• Make reasonable adjustments to ensure people with a learning disability have access to services. 
• Encourage people with a learning disability to register with their GP. 
• Promote Annual Health Checks and ensure the effectiveness of health checks and Health Action Planning. 
• Raise awareness about the importance of health screening. 
• Raise awareness of the importance of healthy lifestyles and support with this where required. 
• Use the Learning from Lives and Deaths Review – people with a learning disability and autistic people (LeDeR) process to identify opportunities to improve health and reduce preventable deaths. 
• Stop over medication of people with a learning disability and autistic people (STAMP/STOMP) (NHS England).  
• Ensure information is accessible and in easy read formats. 
• Ensure unpaid carers are supported with their caring role. 

In Lincolnshire, an integrated approach to commissioning, management and delivery of services for people with a learning disability is well established between health and social care partners. This arrangement includes a Section 75 Agreement between Lincolnshire County Council and the Lincolnshire Integrated Care Board (ICB) with pooled funding for the commissioning of services that support adults with a learning disability with their adult care and/or Continuing Health Care (CHC) needs. A close working relationship between health and social care colleagues ensures people have access to integrated health and social care services and support, supporting person-centred holistic care and support and working together to reduce inequalities and improve the health and wellbeing of people with a learning disability. 

An Autism and Learning Difficulty Outreach Service is provided by Gosberton House Academy and led by the Working Together Team, helping education settings in Lincolnshire to better support autistic children and young people and those with mild, moderate, and severe learning difficulties and social communication challenges which impact on cognitive development and learning potential. 

A Children and Young People (CYP) Keyworker Service is provided by LPFT to support young people up to 25 and the families who are autistic and/or have a learning disability and on the Lincolnshire Dynamic Support Register (DSR) at high-risk of being admitted or already admitted to hospital. 

As part of Lincolnshire’s CYP Mental Health Services, provided by LPFT, a community-based specialist Children and Adolescent Mental Health Services (CAMHS) Learning Disability team offers support to children and young people, aged between 0 to 18 years, who are experiencing significant mental health problems and have a moderate to severe learning disability. 

Through the local Transforming Care Partnership and related Plan, work continues to reduce the number of people with a learning disability who are admitted into inpatient services and to ensure, via timely Care (Education) and Treatment Reviews, people are safe, the care is evidence-based and appropriate, and that plans are in place for their future.  

Recommendations from the LeDeR Report are being implemented to ensure the quality of health and care services for people with a learning disability improves to, ultimately, support a reduction of deaths from preventable conditions.  

Engagement with the Lincolnshire Learning Disability Speak Out Leaders and wider partnership, highlighted that people with a learning disability, like everyone else, want to live gloriously ordinary lives. This includes having good relationships, a home, and for those who can work, a job. Getting around is often a challenge because people with a learning disability often rely on public transport and sometimes worry about being unsafe and/or subjected to abuse. Feeling safe and confident is also an issue when going out on their own, particularly in new and unfamiliar situations.  

Advocacy can be an important enabler for people with learning disabilities, ensuring their voices are heard and choices are respected, promoting independence and inclusion. Advocacy can involve supporting individuals to express views, navigate services, challenge discrimination, and make informed decisions, often by building confidence. 

Parent carers of people with learning disabilities have communicated challenges around getting an overnight break. Whilst provision is available, the quality and suitability of that provision does not always match the needs and wishes of the individual. Work is underway to review the provision, and 360 feedback has been sought too to inform the future model.   

• There is no formal learning disability assessment service or diagnosis route for children and young people or adults in Lincolnshire.  
• We need to improve uptake of national screening programmes to ensure that people with a learning disability can benefit from the better outcomes associated with early diagnosis and treatment. 
• Whilst Lincolnshire has high completion rates for NHS Learning Disability Health checks, the quality and impact of these Health checks are not understood and anecdotal information suggests benefits are lower than intended.  
• Lincolnshire has a higher proportion of working age adults, including those with a learning disability, living in residential care.  
• Evidence of what support and services can prevent, reduce and delay needs, is limited.  
• We need to better understand the need for commissioned respite facilities in Lincolnshire. 

We will continue to work together across Lincolnshire, including continuing to engage and listen to people with learning disabilities and their carers, to reduce health inequalities for people with a learning disability, focusing on increasing healthy life expectancy and avoiding preventable deaths. 

Connect to Work, a Department for Work and Pensions (DWP) funded initiative designed to support individuals with learning disabilities and autistic people into sustained employment, was launched in April 2026. The programme is fully funded by the DWP, with up to £7.5 million annually from April 2025 to March 2030. The delivery model includes both Individual Placement and Support (IPS) and Local Supported Employment (LSE), with LSE supporting more complex cases. The programme is aligned with the Adult Care and Community Wellbeing Improvement Plan and the Government’s ‘Get Britain Working’ strategy. 

Homes for Independence for all people with a care and support need is a priority in the Joint Local Health and Wellbeing Strategy for Lincolnshire. Lincolnshire County Council’s Adult Social Care Strategy outlines the Strategic Goals for Accommodation which will be met through an Adult Care Accommodation Implementation Plan and will include housing options for people with a learning disability. This will ensure that people with a learning disability can access appropriate accommodation within the community and are supported to maximise their independence and lead fulfilling lives. The system response will be overseen by the Housing Health and Ageing Well Delivery Group and will feed into the Lincolnshire Health and Wellbeing Board. 

As part of the Adults Improvement Programme work is underway to develop evidence-based understanding of effective early action and support interventions, this work will inform the future with the intention of supporting more people to live gloriously ordinary lives, using their own natural networks of support. Work is underway through the Better Lives and Community Opportunities programmes, to ensure people are receiving support in the right way and location, supporting the ambition to reduce the use of residential care for all people, including those with a learning disability. Alongside this, the priorities for the Preparation for Adulthood Team are to improve the experience of young people and their families, by engaging at a much earlier point in their journey. This includes ensuring timely, well-coordinated actions that promote strengths based, proportionate, and age-appropriate options by strengthening early identification, planning, and support, to maximise independence, build natural networks around young people, and reduce unnecessary escalation into high-cost, institutional or residential provision.