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Vocational Training in Learning Disabilities for General Practitioners  competency based

The Royal College of General Practitioners
The Learning Disabilities Faculty of the Royal College of Psychiatrists

Contents

Objectives

1. Human Development

(a)   Describe developmental delay and how it varies from normal development

(b)   Describe the biopsychosocial changes which may be associated with developmental disorders

2. Human Behaviour

(a)   Describe ways in which biopsychosocial changes may lead to behavioural changes in the person with learning disabilities

(b)   Discuss how the active or passive behaviour of a person with learning disabilities may alter family dynamics

(c)   Discuss how learning disabilities may be associated with behavioural changes in social relationships and sexual functioning

(d)   Discuss challenging behaviour

(e)   Discuss how behaviour of people with learning disabilities and their carers may impinge on the doctor-patient consultation/relationship

3. Medicine and Society

(a)   Describe influences of culture and ethnicity on people with learning disabilities

(b)   Show a knowledge of the major medical and social agencies, statutory and voluntary, and how they are involved in the care and welfare of people with learning disabilities.

(c)   Show a knowledge of the epidemiology and prevalence of teaming disabilities and also causation of the major associated syndromes.

(d)   Show a knowledge of the living arrangements of people with learning disabilities.

(e)   Show a knowledge of recent legislation and changes in the sphere of learning disabilities relevant to medicine; also competence and consent issues.

(f)     Show a knowledge of the needs of informal (family) carers of people with learning disabilities.

(g)   Describe ethical aspects of the care of people with learning disabilities with particular respect to primary care.

4 Health and Disease

(a)   Show a knowledge of how life events such as change of home, bereavement, unemployment, and physical illness may atypically affect people with learning disabilities

(b)   Describe how acute and chronic illness may present atypically and/or late in people with learning disabilities; how communication problems may compound such difficulties

(c)   Describe common medical conditions associated with learning disabilities such as epilepsy, thyroid disorders, obesity, lack of mobility, incontinence, hormone and digestive disorders

(d)   Have a knowledge of 'dual diagnosis' and how mental illnesses may present atypically Know how to obtain a psychiatric history and use questionnaires to assist in making a diagnosis

(e)   Have an understanding of the particular importance of health education, health promotion and screening for people with learning disabilities

(f)     List the difficulties in taking a clinical history and conducting a physical examinations in patients with learning disabilities

(g)   Discuss obtaining consent before examination and clinical procedures

(h)   Show a knowledge of how treatments may need modification, and of difficulties with compliance, complexity of drug regimes and how learning disability may make side effects more difficult to report

5. The Practice

(a)   The practitioner should organise the practice so that it modifies procedures to accommodate the needs of patients with learning disabilities, in terms of short waiting room times, adequate access for those with mobility problems, and sufficient practitioner time and support to allow unhurried and thorough consultation where necessary

(b)   Liaison and co-operation should be developed with relevant statutory agencies involved in the care of people with learning disabilities

(c)   Where necessary, policies should be developed for working with residential care homes that accommodate patients with learning disabilities, and their support workers to ensure continuity of care

(d)   Ensure that such care promotes the persons identity and dignity

(e)   Demonstrate an understanding of facilitation, health action plans and health checks for young adults in residential care homes
(minimal standard: Care Standards Act 2,000)

Core Syllabus

1 Background Situation

2 Specific Syndromes and Conditions

3 Specialist Services

4 Communication, Consent

5 Medical Problems

6 Consultations

Specialist Medical Practitioner in Learning Disability

Training topics

Interface between Primary Care and LD

Community Care

Screening/Health Promotion

Access to Primary Care

Legislation

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