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Valuing People Now (DH, 2009) recognises that some people, particularly those with complex needs, have been missing out. It has made ‘including everyone’ a priority for the next three years. With reference to Tom's story, this paper will consider the reasons why people with profound and multiple learning disabilities (PMLD) remain among the most marginalised people in society today, what has changed since Valuing People (DH, 2001) and what needs to change in the next three years of delivering Valuing People Now (DH, 2009) if we are to rise to the challenge of ‘enabling extraordinary people to live ordinary lives’ (McConkey, 1998).

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