In this section you will find guidance around DST-PH rating and clinical recommendations
Final Risk Stratification
For the final risk stratification, use the risk rating for the Part 1 and Part 2 in the following matrix to get the final risk rating. The purpose of the tool is to do a risk stratification considering relative risks; it does not replace individual risk assessments.
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Part 2 Rating: Underlying physical health conditions |
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Red |
Amber |
Green |
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Part 1 Rating: Factors impacting on physical health outcomes |
Red |
RED |
AMBER |
GREEN |
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Amber |
AMBER |
AMBER |
GREEN |
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Green |
GREEN |
GREEN |
GREEN |
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If the DST-PH is filled in using this tool, then the final risk stratification will be automatically calculated and as risk scores are inputted.
Once you have the final risk stratification, you will be able to access which clinical recommendation to use. This will be Green (Low Risk), Amber (Medium Risk) or Red (High Risk). You can find these recommendations in the tool by using the tabs along the bottom.
We have also included the clinical recommendations below.
Individuals who are rated in this area may still have physical and mental health needs. This is an indication that any current health concerns are being well managed or any physical health issues are being addressed with plans in place to manage areas of physical health need.
It is important to make sure the person is on the GP learning disability register and invited to access the GP practice to ensure any physical health needs are identified and responded to with appropriate treatments being in place, including any investigations. This should include; Annual Health Checks, immunisations and screening, routine face to face appointments and monitoring of identified health conditions.
Were a person requires additional support or adaptations to enable access to health care a number of interventions are detailed below to consider:
Additional areas of clinical intervention could include:
Making a Reasonable Adjustments - Reasonable adjustments can mean alterations to buildings but may also mean changes to policies, procedures and staff training to ensure that services work equally well for people with learning disabilities.
Guides on how reasonable adjustments should be made to health services and adjustments to help people with learning disabilities to access services can be obtained from:
A reasonable adjustment checklist can be used to help identify the level of support a person needs to enable access to healthcare including GP surgery – see appendix 1.
Improving Communication
People with a learning disability have a reduced ability to understand complex information and learn new skills. Effective communication is essential, to a person receiving good quality healthcare and a high number of people with learning disabilities need assistance with communication.
To support people's communication and information needs in line with Accessible information standard: NHS England's Accessible Information Standard.
This could also include:
- A flag placed on GP record to indicate what support the person needs and would like.
- Easy read information for investigations, medical procedures, treatments and immunisations.
- Providing priority and longer appointments.
Further support and guidance can be provided by the local specialist learning disability team
This rating indicates that the person requires specialist intervention surrounding their physical health. The people rated in this category are at high risk of physical health decline and premature mortality without appropriate actions and direct interventions being put in place. This needs to include a multi-disciplinary approach involving a range of professional, family and carers.
Action Needed
A referral to be made to local Specialist Community Learning Disability Team.
Consider health coordination in discussion with Community Learning Disability Team - In general this should be member of the community learning disability team but in few cases this might be practice nurse of Specialist Learning Disability Health Facilitator.
Additional areas of clinical intervention could include:
Making a Reasonable Adjustments - Reasonable adjustments can mean alterations to buildings but may also mean changes to policies, procedures and staff training to ensure that services work equally well for people with learning disabilities.
Guides on how reasonable adjustments should be made to health services and adjustments to help people with learning disabilities to access services can be obtained from:
A reasonable adjustment checklist can be used to help identify the level of support a person needs to enable access to healthcare including GP surgery – see appendix 1.
Improving Communication
People with a learning disability have a reduced ability to understand complex information and learn new skills. Effective communication is essential, to a person receiving good quality healthcare and a high number of people with learning disabilities need assistance with communication.
To support people's communication and information needs in line with Accessible information standard: NHS England's Accessible Information Standard.
This could also include:
- A flag placed on GP record to indicate what support the person needs and would like.
- Easy read information for investigations, medical procedures, treatments and immunisations.
- Providing priority and longer appointments.
Further support and guidance can be provided by the local specialist learning disability team
This rating indicates that the person requires urgent specialist intervention surrounding their physical health. The people rated in this category are at a significant risk of physical health decline and premature mortality without appropriate actions and direct interventions being put in place.
Immediate Action Needed
An urgent referral to be made to local Specialist Community Learning Disability Team.
Learning Disability Professional to liaise with Primary Care to ensure:
- Agreement for individual to have named Primary Care professional to coordination healthcare (this could be in collaboration with LD Health facilitator)
- An urgent multi agency healthcare review to be arranged to ensure delivery of a robust and high level of integrated care.
- Clear and robust treatment and Health Action plan to be developed to address health needs.
Additional areas of clinical intervention could include:
Making a Reasonable Adjustments - Reasonable adjustments can mean alterations to buildings but may also mean changes to policies, procedures and staff training to ensure that services work equally well for people with learning disabilities. A reasonable adjustment checklist can be used to help identify the level of support a person needs to enable access to healthcare including GP surgery. To view this checklist please click here.
Guides on how reasonable adjustments should be made to health services and adjustments to help people with learning disabilities to access services can be obtained from the gov.uk website.
A reasonable adjustment checklist can be used to help identify the level of support a person needs to enable access to healthcare including GP surgery – see appendix 1.
Improving Communication
People with a learning disability have a reduced ability to understand complex information and learn new skills. Effective communication is essential, to a person receiving good quality healthcare and a high number of people with learning disabilities need assistance with communication.
To support people's communication and information needs in line with Accessible information standard: NHS England's Accessible Information Standard.
This could also include:
- A flag placed on GP record to indicate what support the person needs and would like.
- Easy read information for investigations, medical procedures, treatments and immunisations.
- Providing priority and longer appointments
