The Ignored Minority: Meeting the Needs of People with Profound Learning Disability

This paper describes how one specialist learning disability health service has attempted to increase its focus on meeting the complex needs of people with profound learning disability (PLD) both with and without additional physical, sensory and medical impairment. Through individual assessment and intervention, carer consultation, training and supervision, research, and audit and advice to management, a multi‐disciplinary group has influenced the development of more proactive community teams for people with learning disability. This is in the context of both the publication of Signposts for Success (NHSE, 1998) and of a changing organisational culture which has embraced essential lifestyle planning, person‐centred teams, supported living and direct payments. The challenge remains of ring‐fencing sufficient resources (of time, skill and equipment), given the high‐profile and competing demands of people with milder learning disabilities but with complex mental health needs and/or challenging behaviour.