The health of people with learning disability is often poorer than the rest of the population. Sometimes the cause of the ill health is genetic, associated with the cause of the learning disability, for example people with Down’s syndrome have a greater likelihood of having heart disease and therefore their life expectancy may be shorter. There is also a greater chance of services not being accessible for a number of reasons, so that, for example, uptake of screening services is poorer in people with learning disability[Pearson V et al (1998): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1113417/]. Recognition of this has resulted in local work to provide services which are equitable[http://www.ndti.org.uk/uploads/files/Screening_Services_Strategy_Toolkit_final.pdf]. For those with physical disability or a sensory disability, lack of access to, or absence of, services can lead to a greater health need. Next year’s report will consider these areas in more detail.