Disability benefits, people with learning disabilities and autistic people - 2026 update

 
It's been a while since I looked at disability benefit statistics, people with learning disabilities and autistic people, so this blogpost updates one from 2023, with figures mainly up to May 2025. All these figures are obtained from the excellent DWP Stat-Xplore online tool. I’m going to talk about three disability benefits here:

1) Disability Living Allowance. The Disability Living Allowance (DLA) is a tax-free benefit for disabled people who need help with mobility or care costs. Disability Living Allowance (except for those born before 9 April 1948 and those aged under 16 at the time of application) is being replaced by Personal Independence Payments. The DLA consists of two components which are assessed and paid separately, a Care Award (paid at higher, middle and lower rates) and a Mobility Award (paid at higher and lower rates).

The Department for Work and Pensions (DWP) provides quarterly information on Disability Living Allowance (DLA), that can be disaggregated for adults with ‘learning difficulties’ in England. The DWP definition of ‘learning difficulties’ includes ‘learning difficulties’’ (an old generic code still used for pre-2008 cases before more detailed sub-categories were introduced), ‘Down’s syndrome’, ‘Fragile X syndrome’, ‘learning disability – Other/type not known’, ‘Autism’, ‘Asperger syndrome’, and ‘Retts disorder’². This definition is much broader than other government departments’ definitions of the population of people with learning disabilities.

2) Attendance Allowance (AA), which is paid to disabled people over the age of 65 to help with personal care. This can be paid at two rates to reflect the level of care required, and in the statistics uses the same broad definition of ‘learning difficulties’ as the DLA statistics.

3) Personal Independence Payment (PIP); a benefit for adults with sickness and/or disability replacing the DLA, but with some important differences. Information on the PIP is available on a monthly basis for adults with learning disabilities, under the category ‘Main Disabling Condition/Psychiatric Disorders/Learning Disability Global’, and for autistic people under the label ‘Main Disabling Condition/Psychiatric Disorders/Autistic Spectrum Disorders’. Aspects of the PIP are being reviewed by the government in the Timms review.

In this blogpost I’m trying to get a sense of how many people with learning disabilities and autistic people (I’m assuming that the broader category of ‘learning difficulties’ is mainly these two groups of people) have been getting some form of disability benefit over time. To help with this, I’ve looked at four broad age groups: children and young people (age 0-15 for DLA); younger working age adults (age 16-44 for DLA and PIP); older working age adults (age 45-64 for DLA and PIP); and older adults (age 65+ for DLA, PIP and AA). The graphs include people getting payment for the benefit concerned, and are either people with ‘learning difficulties’ (DLA and AA) or, separately, people with learning disabilities and autistic people (PIP).

What do we find? The first graph shows how many children and young people with ‘learning difficulties’ received DLA (the only one of these three benefits where children and young people are eligible), from May 2012 to May 2025. The graph shows a steady increase in the number of children and young people with ‘learning difficulties’ getting DLA, with a faster rate of increase in recent years, up to 351,719 children and young people in May 2025.

The next graph below shows information for younger working age adults (aged 16 to 44), from May 2012 to May 2025, and includes both the DLA and the introduction of the PIP. As more and more people transferred from DLA to PIP there was a rapid decrease in the number of younger working age adults with ‘learning difficulties’ getting the DLA up to May 2020, after which numbers have stayed fairly stable. 

During the time that the number of people getting DLA was decreasing, there were similar rises over time in the number of people with learning disabilities and autistic people getting a PIP. However, from May 2020 increases for people with learning disabilities have very small, compared to the sustained and substantial increase for autistic people. In May 2020, there were fewer young autistic adults getting a PIP (82,123 people) than young adults with learning disabilities (88,251 people). By May 2025, there were nearly twice as many young autistic adults getting a PIP (201,820 people) than young adults with learning disabilities (101,789 people).

The grey line in this graph shows the combined total of people getting one of these disability benefits. This shows some fluctuations over time, with year-on-year increases punctuated by a dip in 2016, no real change from 2018 to 2020, and a steady increase from 2020. By May 2025 340,369 younger working age adults with learning difficulties, learning disabilities, or autistic younger working age adults, were getting either DLA or PIP.

The third graph, below, has the same information for older working age adults with learning difficulties aged 45-64 (note that the vertical scale for this graph is different to the previous ones, as the overall numbers are much smaller). This graph also shows a rapid decrease in the number of people getting DLA from 2012 to 2020, and continuing to slowly drop since. 

There was a sharp rise in the number of people with learning disabilities getting PIP up to 2020 but numbers have stayed fairly stable since, with relatively few but slowly increasing numbers of autistic people getting PIP. The combined total for this age group shows a much slower rate of increase for people getting either disability benefit, with a dip from 2018 to 2020 and small increases from 2020 onwards. By May 2025 64,195 older working age adults with learning difficulties, learning disabilities, or autistic older working age adults, were getting either DLA or PIP.

The final graph (again with a different vertical scale as the number of people is much smaller again) has information on the number of older people with ‘learning difficulties’ (DLA, AA) or older people with learning disabilities or autistic people (PIP) getting one of these disability benefits. The number of older adults with learning difficulties getting AA is relatively small and has gradually declined from 2012 to 2025. 

Continuing decreases in the number of older people getting DLA is accompanied by a sharp and continuing increase in the number of older adults with learning disabilities getting PIP, and relatively few but gradually increasing numbers of older autistic adults getting PIP. Overall, the number of older adults with learning difficulties, learning disabilities or autistic older adults getting one of these disability benefits has steadily increased from 2012 to 2025. By May 2025 22,598 older adults with learning difficulties, learning disabilities, or autistic older adults, were getting either DLA, AA or PIP.

Overall, the number of children and young people with 'learning difficulties' and the number of younger working age adults, particularly autistic adults, getting disability benefits has continued to increase over time, even (after a blip) with the introduction of PIP. After the initial introduction of PIP, the number of young working age adults with learning disabilities getting PIP has only increased very slowly over time.

This is in contrast to older working age adults, when there have been very small increases in the number of people getting disability benefits for some years. Since the transfer of DLA to PIP, this increase has been amongst older working age autistic adults, with the number of older working age adults with learning disabilities getting PIP staying static from 2021 onwards

For older people aged 65+, there was a very gradual but steady increase in the numbers of older people with learning disabilities and autistic people getting some form of disability benefit, as the transfer from DLA to PIP appears to be incomplete. 

For me, a few questions come out of this.

For the younger age groups, most of the increase in the number of people getting disability benefits may be largely being driven by an increase in the number of autistic people getting a disability benefit, which is not happening in the older age groups - is this perhaps a function of diagnostic services prioritising children and young people? 

Where people with learning disabilities are identifiable (all the adult age groups), from May 2020 onwards there has been little or no increase in the number of people with learning disabilities getting a disability benefit, which is particularly pronounced in the older working age adult group (45-64 years). Is this some combination of a continuing tightening of eligibility criteria for adults with learning disabilities, combined with the impact of the COVID-19 pandemic on the lives and deaths of middle-aged and older people with learning disabilities where 55-64 years was the peak age of death for people with learning disabilities?

Finally, if the increases that are evident among young groups of people (particularly autistic people) are sustained, and move through into older age groups, what will this do to the already tightening eligibility criteria for any sort of support for people?

The Health and Care of People with Learning Disabilities dataset: High blood pressure and cardiovascular disease

 Note: if you want to skip the graphs, go straight to the conclusions for a quick summary...

We've known for a long time about the health inequities experienced by people with learning disabilities. We know these health inequities are big, resulting in much earlier typical ages of death compared to other people, and we know that these health inequities cut across a wide range of health conditions.

This blogpost will summarise some recent information about people with learning disabilities relating to high blood pressure, and diseases of the heart and blood circulation. 

This blogpost is the third of a series going into a lot of detail using information from the 'Health and Care of People with Learning Disabilities' dataset, compiled by NHS England. Every year (going April to March), this has taken information from GP information systems in England to produce statistics about the health and health treatment of people registered with a GP as a person with learning disabilities, often comparing them to the health and healthcare of people without learning disabilities. It's a brilliant source of information that isn't used as much as it should be, and this is the final year when information in this format will be made available. The interactive information tool is quite hard to get your head around but it does make it quite flexible - for many things you can look at how things are by age, sex, region and even more locally than that, and for most things you can look back over at least the last five years. The most recent information available covers April 2024 to March 2025.

Before we start, there are a few cautions to bear in mind about this dataset. The information only covers about 6 in 10 people registered with a GP (54.6%), and coverage across different parts of the country is really patchy. There are also many people with learning disabilities who are not registered as such with their GP. Finally, it's really important to remember that all this information is based on what health systems and GPs record, which is likely to have its own biases, particularly when it comes to people with learning disabilities.

High blood pressure/hypertension

High blood pressure (also known as hypertension) often has no obvious signs, although it is easy to measure, and is a major risk factor for all sorts of health problems. 

In 2024/25, across all age groups fewer people with learning disabilities (11.1%) had an active diagnosis of hypertension than people without learning disabilities (13.7%). Rates of diagnosed hypertension have increased faster for people with learning disabilities (from 9.7% of people in 2017/18 to 11.1% of people in 2024/25) than for other people (from 12.9% of people in 2017/18 to 13.7% in 2024/25). For both groups most of this increase has happened in the last three years, so it may partly reflect more widespread blood pressure testing.

In terms of sex (the term used in the dataset), more girls/women (12.2% in 2024/25) than boys/men (10.5% in 2024/25) with learning disabilities had a diagnosis of hypertension, where there was no difference between sexes for people without learning disabilities (both 13.7%). 

In terms of age bands, there are higher rates of diagnosed hypertension amongst people with learning disabilities at all age bands up to 64 compared to people without learning disabilities, with rates of diagnosed hypertension increasing with age. Although rates of diagnosed hypertension continue to rise from the age of 65 onwards, older people with learning disabilities are less likely than other people to diagnosed with hypertension.

Major efforts are being made to increase blood pressure measurement/screening, as high blood pressure is a risk factor for so many health problems. 

In 2024/25, most people with learning disabilities (83.4%) had had their blood pressure checked in the last five years, with this figure increasing over time (from 80% in 2017/18). Fewer people without learning disabilities had had their blood pressure checked in the last five years (55.7% in 2024/25), with this figure reducing from the Covid-19 pandemic onwards (from 61.9% in 2017/18).

In terms of sex (the term used in the dataset), slightly more girls/women (85.4% in 2024/25) than boys/men (82.1% in 2024/25) with learning disabilities had had their blood pressure checked in the last five years; this difference was much bigger for people without learning disabilities (girls/women 64.1% in 2024/15; boys/men 47.3%). 

In terms of age bands, rates of blood pressure checks amongst people with learning disabilities increase sharply from childhood to young adulthood, with over 90% of people having blood pressure checks from age 25 onwards. Rates of blood pressure checks increase more gradually for people without learning disabilities, only reaching 90% from the age of 65.

Cardiovascular disease

The Health and Care dataset has very similar information about various types of cardiovascular disease (an umbrella term for all diseases of the heart and circulation of the blood), including coronary heart disease, heart failure, chronic obstructive pulmonary disease (COPD) and stroke.

Coronary heart disease. The graph below shows rates of diagnosed coronary heart disease recorded for people with and without learning disabilities over time, from 2017/18 to 2024/25. Overall, in 2024/25 people with learning disabilities were less likely to have a diagnosis of heart disease than other people (1.2% vs 2.6%), a figure which has stayed fairly stable for people with learning disabilities (from 1.1% in 2017/18) but has gradually decreased for people without learning disabilities (from 2.9% in 2017/18). 

Amongst people with learning disabilities, girls/women are less likely to be diagnosed with coronary heart disease (1% in 2024/25) than boys/men (1.3% in 2024/25), a much smaller gap than amongst other people (girls/women 1.8% in 2024/25; boys/men 3.5%).

In terms of age bands, although rates are relatively low up to age 54 they are marginally higher for people with learning disabilities than other people - as rates continue to increase from the age of 55 onwards they become much higher for people without learning disabilities compared to people with learning disabilities.

Heart failure. In contrast to the figures above for coronary heart disease, in 2024/25 people with learning disabilities were more likely to have a diagnosis of heart failure than other people (1.3% vs 1.1%), a figure which has slowly increased for people with learning disabilities (from 1% in 2017/18) and people without learning disabilities (from 0.9% in 2017/18). 

Amongst people with learning disabilities, girls/women are slightly more likely to be diagnosed with heart failure (1.3% in 2024/25) than boys/men (1.2% in 2024/25), a different pattern than amongst other people (girls/women 0.9% in 2024/25; boys/men 1.3%).

In terms of age bands, rates of heart failure are consistently higher for people with learning disabilities than other people at all ages up to the age of 74.

Chronic Obstructive Pulmonary Disease (COPD). Overall, in 2024/25 people with learning disabilities were less likely to have a diagnosis of COPD than other people (1.3% vs 1.8%), a figure which has slowly increased for people with learning disabilities (from 1.1% in 2017/18) but stayed static for people without learning disabilities (1.8% in 2017/18). 

Amongst people with learning disabilities, in 2024/25 girls/women were slightly more likely to be diagnosed with COPD (1.4%) than boys/men (1.2%), although over time this figure has increased for girls/women with learning disabilities (from 1% in 2017/18) but stayed static for boys/men with learning disabilities (1.2% in 2017/18). Amongst other people, figures are similar for girls/women (1.8% in 2024/25) and boys/men (1.9%).

In terms of age bands, rates of diagnosed COPD are consistently higher for people with learning disabilities than other people at all ages up to the age of 64 - beyond this COPD is more commonly diagnosed amongst people without learning disabilities.

Stroke or transient ischaemic attack (TIA). Overall, in 2024/25 people with learning disabilities were slightly more likely to have a diagnosis of stroke or TIA than other people (1.8% vs 1.7%), a figure which has slowly increased for people with learning disabilities (from 1.6% in 2017/18) and people without learning disabilities (1.6% in 2017/18). 

Amongst people with learning disabilities, in 2024/25 girls/women were more likely to be diagnosed with stroke or TIA (2%) than boys/men (1.6%) - over time this figure has increased for girls/women with learning disabilities (from 1.8% in 2017/18) but stayed static for boys/men with learning disabilities (1.6% in 2017/18). Amongst other people, figures for girls/women (1.6% in 2024/25) are slightly lower than for boys/men (1.8%).

In terms of age bands, rates of diagnosed stroke or TIA are consistently higher for people with learning disabilities than other people at all ages up to the age of 74.

Conclusions

In this blogpost we're seeing similar patterns to those we saw in the previous blogpost about diabetes.

Across a range of diseases of the heart or circulation of the blood (cardiovascular diseases), and also for high blood pressure (hypertension), overall people with learning disabilities are less likely to be diagnosed than people without learning disabilities.

But this overall pattern masks what's happening at different ages. For almost all these cardiovascular diseases, at younger ages when they are less commonly diagnosed, rates of these diseases are higher for people with learning disabilities than for other people. It is only at older ages (65 or older), when these diseases are more common and when people with learning disabilities are less likely to have survived, that these diseases are more common amongst people without learning disabilities. 

There are also often different patterns in rates of disease when it comes to men and women with learning disabilities compared to men and women without learning disabilities. 

We know nothing about rates of cardiovascular diseases among different ethnic communities of people with learning disabilities. 

For me, this suggests that health services set up to screen, prevent (if possible) and treat cardiovascular diseases among people generally will be looking in the wrong places when it comes to people with learning disabilities, particularly when the number of people with learning disabilities will be relatively small in the crowds of people coming to their attention.

As we saw with blood glucose checks for people with diabetes, a large majority of adults with learning disabilities registered with GPs have had a blood pressure check in the last five years (although five years can be a long time in terms of checking blood pressure), probably a function of annual health checks for people with learning disabilities. But as with diabetes, is regular checking resulting in better prevention and treatment for people with learning disabilities with potential heart and circulation problems? 

I suspect that the answer to this question is likely to be no. I've been looking at the most recent LeDeR report for 2024, published in July 2026. One of the headlines repeatedly reported is about avoidable deaths, where in 2024 almost two fifths of people with learning disabilities whose deaths were reported to LeDeR had a death judged to be avoidable (39%), almost twice as many avoidable deaths as those in the 'general' population (21.1%). A horrific inequity.

The LeDeR report also breaks this down into two broad types of avoidable death:

• 'Preventable' deaths ("deaths that could potentially be avoided (prevented) through effective public health and primary prevention measures, such as vaccination, screening, and lifestyle interventions") and
• 'Treatable' deaths ("deaths that could potentially be avoided through timely and effective healthcare, including early diagnosis, appropriate treatment, and prompt management of deterioration"

In the LeDeR report appendix, figures for preventable deaths aren't that different for people with learning disabilities (14.0%) and the 'general' population (13.5%). But the figures for treatable deaths, which by definition are deaths that health services can do something about, are something else. Fully a quarter (25%) of the deaths of people with learning disabilities were from treatable causes, and were more than three times more likely than for the 7.6% of deaths of the general population.

Across a lot of health conditions, the picture is of existing inequities between people with and without learning disabilities generally getting bigger over time, rather than gaps closing. In the United Kingdom, we have known about these inequities for at least 50 years and counting. Can someone give me a good reason why we shouldn't call this social murder?

The Health and Care of People with Learning Disabilities dataset: Diabetes

Note: if you want to skip the graphs, go straight to the conclusions for a quick summary...

We've known for a long time about the health inequities experienced by people with learning disabilities. We know these health inequities are big, resulting in much earlier typical ages of death compared to other people, and we know that these health inequities cut across a wide range of health conditions.

This blogpost will summarise some recent information about people with learning disabilities with a diagnosis of diabetes. 

This blogpost is the second of a series going into a lot of detail using information from the 'Health and Care of People with Learning Disabilities' dataset, compiled by NHS England. Every year (going April to March), this takes information from GP information systems in England to produce statistics about the health and health treatment of people registered with a GP as a person with learning disabilities, often comparing them to the health and healthcare of people without learning disabilities. It's a brilliant source of information that isn't used as much as it should be. The interactive information tool is quite hard to get your head around but it does make it quite flexible - for many things you can look at how things are by age, sex, region and even more locally than that, and for most things you can look back over at least the last five years. The most recent information available covers April 2024 to March 2025, with updates usually released every year in December.

Before we start, there are a few cautions to bear in mind about this dataset. The biggest one is that the information only covers about 6 in 10 people registered with a GP (54.6%) - not all the companies that own the electronic information systems used by GPs allow their data to be used (!). So coverage across different parts of the country is really patchy. The second caution is that there are likely to be many people with learning disabilities who are not registered as such with their GP. A third caution is that the extent to which this dataset includes people with learning disabilities in inpatient units really isn't clear. Finally, it's really important to remember that all this information is based on what health systems and GPs record, which is likely to have its own biases, particularly when it comes to people with learning disabilities.

Type 1 diabetes

Type 1 diabetes is an autoimmune condition where the pancreas stops producing insulin. The body attacks the healthy pancreas cells by mistake which causes it to stop producing insulin which the body needs to regulate blood sugar. Type 1 diabetes often runs in families and you are more likely to develop the condition if a close relative has the disease. Unlike Type 2 diabetes, there is no link between being overweight or inactive and developing the condition.

In 2024/25, 0.8% of people with learning disabilities had a diagnosis of Type 1 diabetes mellitus, compared to 0.4% of people without learning disabilities. These percentages haven't changed much from 2017/18 (0.7% of people with learning disabilities; 0.4% of people without learning disabilities). [I know the graph looks odd in terms of changes over time for different groups, but I've checked it multiple times and it's a quirk of rounding numbers up or down].

In terms of sex (the term used in the dataset), slightly more girls/women (0.8% in 2024/25) than boys/men (0.7% in 2024/25) with learning disabilities had a diagnosis of Type 1 diabetes, a similar difference (0.5% vs 0.4%) to people without learning disabilities. 

In terms of age bands, there are higher rates of Type 1 diabetes amongst people with learning disabilities at all age bands up to 64 compared to people without learning disabilities, peaking at 1.0% of people with learning disabilities aged 25-34. From the age of 65 onwards people with learning disabilities are equally or less likely than other people to have Type 1 diabetes, with no-one with learning disabilities aged 75+ reported as having Type 1 diabetes (compared to 0.3% of people without learning disabilities).

Type 2 diabetes

The Health and Care dataset has very similar information about diagnosis of what it describes as non-type 1 diabetes mellitus, which I am taking to mean Type 2 diabetes. Type 2 diabetes is a condition affecting the pancreas which leads to disruption of the hormone insulin and high blood sugars. Risk factors include being overweight, inactivity, having a family history of diabetes, or being from certain ethnic backgrounds. If left untreated, diabetes can lead to uncontrolled blood sugar, poor circulation and consequent damage to feet (including amputations) and eye problems.

The graph below shows rates of non-Type 1 diabetes recorded for people with and without learning disabilities over time, from 2017/18 to 2024/25. Overall, the percentage of people with learning disabilities diagnosed with non-Type 1 diabetes has increased over time, from 6.7% of people in 2017/18, to 8.0% of people in 2024/25. There has also been a less steep increase for people without learning disabilities (from 4.7% of people in 2017/18 to 5.5% of people in 2024/25). Rates of diagnosed non-Type 1 diabetes overall are higher for people with learning disabilities compared to other people, with the gap widening over time.

Amongst people with learning disabilities, girls/women are more likely to be diagnosed with non-Type 1 diabetes (9.0% in 2024/25) than boys/men (7.4% in 2024/25). This is the opposite pattern to people without learning disabilities, where girls/women are less likely to be diagnosed with non-Type 1 diabetes (4.9% in 2024/25) than boys/men (6.1% in 2024/25).

In terms of age bands, there are higher rates of non-Type 1 diabetes for people with learning disabilities overall at all ages from 10 onwards, with 8.5% of people with learning disabilities aged 35-44 having a diagnosis of non-Type 1 diabetes compared to 2.2% of other people, and 15% or more of people with learning disabilities having a diagnosis of non-Type 1 diabetes from the age of 45 onwards. While rates of non-Type 1 diabetes are higher for girls/women with learning disabilities than boys/men with learning disabilities up to the age of 44, this flips from the age of 45 onwards.

Measuring blood glucose

The Health and Care of People with Learning Disabilities dataset also records how many people with a diagnosis of diabetes mellitus (Type 1 and Type 2) have had their blood glucose measured in the last 12 months (HbA1c), as a way of checking how well people are generally doing in managing their diabetes. This is a basic measure of how well health services are regularly monitoring people with diabetes - it doesn't say anything about how well people are managing their diabetes or what help people are getting beyond regular monitoring.

The graph below shows what percentage of people have a diagnosis of diabetes and have had their blood glucose checked in the last 12 months, from 2017/18 to 2024/25. For people with learning disabilities in 2024/25, 8.1% of people had had their blood glucose checked - this is compared to the 8.8% of people with learning disabilities in 2024/25 with a diagnosis of either Type 1 or Type 2 diabetes. So most people with learning disabilities and diabetes, but by no means everyone, had had their blood glucose checked in the last 12 months. For people without learning disabilities in 2024/25, 5.4% of people had had a blood glucose test in the last 12 months, out of the 5.9% of people with a diagnosis of Type 1 or Type 2 diagnosis. 

For people with and without learning disabilities, the percentage of people getting a blood glucose test has increased over time. For people with learning disabilities, this is an increase from 6.8% of people in 2017/18 to 8.1% of people in 2024/25; for other people this is an increase from 4.7% of people in 2017/18 to 5.4% of people in 2024/25. This has been a steady year-on-year increase, except for a dip during the Covid-19 pandemic in 2020/21.

But as we've seen earlier on, the percentage of people with learning disabilities with a diagnosis of diabetes has also increased over time, and at a faster rate than for people without learning disabilities. This means that the gap between people with a diagnosis of diabetes and those with a blood glucose test has increased slightly over time for people with learning disabilities (the gap was 0.6% of people in 2017/18 compared to 0.7% of people in 2024/25). 

As we saw earlier, in relation to diabetes diagnoses, more girls/women with learning disabilities than boys/men in 2024/25 had had their blood glucose checked in the last 12 months (9.1% vs 7.5%). This is the opposite way round for girls/women vs boys/men without learning disabilities (4.8% vs 5.9% in 2024/25).

In terms of age bands, the age pattern of blood glucose checks closely mirrors the age pattern of diabetes diagnoses (particularly for the more common non-Type 1 diabetes) that we saw earlier, being much more common for people with learning disabilities at virtually all ages.

Taking into account differences in the populations of people with and without learning disabilities in things like age and sex, in 2024/25 a diagnosis of Type 1 diabetes was 1.6 times as common and a diagnosis of non-Type 1 diabetes 1.9 times as common among people with learning disabilities than you would expect. 

Conclusions

Both Type 1 and Type 2 diabetes are more commonly diagnosed amongst people with learning disabilities compared to other people, and are increasing faster over time. In 2024/25, around 1 in 11 people with learning disabilities had some form of diabetes diagnosis, compared to 1 in 17 people without learning disabilities.

These differences are biggest in almost all adult age groups.

Girls/women with learning disabilities are more likely than boys/men with learning disabilities to have a diagnosis of Type 2 diabetes and to have blood glucose checks - this is the opposite way round to the population of people without learning disabilities.

This dataset doesn't tell us anything about ethnicity and diabetes amongst people with learning disabilities, which we know is an important issue among people without learning disabilities.

Most (but not all) people with learning disabilities with a diagnosis of diabetes are getting a regular blood glucose check - this is increasing over time, but is not quite keeping pace with the increasing numbers of people with learning disabilities with a diagnosis of diabetes.

There are also a few things I want to say about this that will come up time and time again (if I ever get round to other blogposts about this dataset)...

1) I think this info shows the value of the huge effort involved in setting up regular health checks for people with learning disabilities, as long as they are done well. I suspect that annual health checks have been crucial in spotting diabetes (especially Type 2 diabetes) and in regularly monitoring people's diabetes, particularly among younger adults with learning disabilities.

2) However, while this monitoring clearly has important benefits for aspects of people's health, monitoring on its own is not enough. The evidence for weight management or physical activity programmes working well for people with learning disabilities is not brilliant, and we are not paying any attention to the 'causes of the causes' (in Sir Michael Marmot's phrase) like poverty and where people are living. 

3) I think the information about age is really important and is often overlooked. For diabetes (and for a whole host of other health issues) we see a clear pattern of health problems starting much earlier for more people with learning disabilities. Which is unlikely to be where GPs and health services are generally expecting to see, or be screening for, these health problems. It's also the case that among people without learning disabilities, many health conditions are most common at much older ages. Bluntly, many people with learning disabilities don't live that long, so overall figures across all age groups tend to minimise health inequities between people with and without learning disabilities.

4) Relating to the point just above, it's important to remember that although percentages of health issues like diabetes are more common amongst people with learning disabilities, in terms of absolute numbers of people they can be swamped by the numbers of people without learning disabilities. The Health and Care of People with Learning Disabilities dataset covers 55% of people in GP practices in England - scaling up figures from the dataset would mean there are just over 28,000 people with learning disabilities diagnosed with Type 2 diabetes in England, compared to 3.5 million people without learning disabilities. Easy to ignore in mainstream health services, or an easily manageable number of people for health services to pay attention to and make a big difference?

The Health and Care of People with Learning Disabilities dataset - how many people are taking mental health medications?

Note: if you want to skip the graphs, go straight to the conclusions for a quick summary...

For over 30 years, it's been clear that huge numbers of people with learning disabilities in England (and in other places too) are prescribed (told by their doctor to take) what are sometimes called 'psychotropic' drugs - drugs that are prescribed to change something about a person's mental state. Typically, these are drugs prescribed for reasons of 'mental health', although they might also be prescribed to change a person's behaviour. Recent research led by Sue Caton at Manchester Metropolitan University with co-researchers with learning disabilities has shown that people with learning disabilities are often not involved in decisions about what mental health medications they're taking (this link goes to a toolkit produced by the project that might help people get more involved in these decisions).

In England, NHS England and other organisations have been running the STOMP programme since 2016. STOMP stands for 'Stopping over medication of people with a learning disability, autism or both'. More recently STAMP ('Supporting Treatment and Appropriate Medication in Paediatrics) has been added by NHS England. Part of the aim of both these programmes is to reduce the number of people with learning disabilities and autistic people who are prescribed these drugs.

This blogpost will summarise some recent information about the percentages of people with learning disabilities being prescribed a range of mental health drugs. 

This blogpost will be the first of a series going into a lot of detail using information from the 'Health and Care of People with Learning Disabilities' dataset, compiled by NHS England. Every year (going April to March), this takes information from GP information systems in England to produce statistics about the health and health treatment of people registered with a GP as a person with learning disabilities, often comparing them to the health and healthcare of people without learning disabilities. It's a brilliant source of information that isn't used as much as it should be. The interactive information tool is quite hard to get your head around but it does make it quite flexible - for many things you can look at how things are by age, sex, region and even more locally than that, and for most things you can look back over at least the last five years. The most recent information available covers April 2024 to March 2025, with updates usually released every year in December.

There are a few reasons that I want to go into mind-numbing detail this time around (it's not ONLY that I like graphs). First, I'm not going to be doing these blogposts for ever, so I want to make the ones I do as full of information as possible for completeness. Second, I want to show what these kinds of datasets can do, in the hope that people will keep using them. Third, a recent 'consultation' has said that this is the last year that this dataset in this format will be produced. It will be replaced by something that might have more information and will cover all GP practices (a very welcome development), but will not have any way of directly comparing people with learning disabilities to people without learning disabilities (which is such a useful feature of the dataset as it stands).

Before we start, there are a few cautions to bear in mind about this dataset. The biggest one is that the information only covers about 6 in 10 people registered with a GP (54.6%) - not all the companies that own the electronic information systems used by GPs allow their data to be used (!). So coverage across different parts of the country is really patchy. The second caution is that there are likely to be many people with learning disabilities who are not registered as such with their GP. A third caution is that the extent to which this dataset includes people with learning disabilities in inpatient units really isn't clear. Finally, it's really important to remember that all this information is based on what health systems and GPs record, which is likely to have its own biases, particularly when it comes to people with learning disabilities.

'Severe mental illness' and antipsychotics

Antipsychotics are a set of drugs that are supposed to be prescribed for people with mental health issues with labels such as psychosis, which in GP-record world (along with some other mental health issues) are classed as 'severe mental illness'.

In 2024/25, 7.6% of people with learning disabilities were diagnosed with a 'severe mental illness', compared to 1.0% of people without learning disabilities. A clutch of research projects have shown that mental health issues such as psychosis might be more common amongst people with learning disabilities, but nowhere near to the extent that GPs are diagnosing severe mental illness, with the suspicion that some people with learning disabilities are getting this label to justify them being prescribed antipsychotic drugs for reasons essentially of attempted behavioural control. These percentages haven't changed much from 2017/18 (7.6% of people with learning disabilities; 0.9% of people without learning disabilities).

In terms of sex (the term used in the dataset), more girls/women (8.0% in 2024/25) than boys/men (7.4% in 2024/25) with learning disabilities had a severe mental illness diagnosis, while there was no difference amongst people without learning disabilities. 

In terms of age bands, substantially more people with learning disabilities are diagnosed with severe mental illness from an early age (e.g. 10% or more from the age of 35-44 onwards) than people without learning disabilities, peaking at 16.3% of people with learning disabilities aged 65-74.

Antipsychotics. Overall, in 2024/25 13.8% of people with learning disabilities were being prescribed antipsychotics, compared to 0.9% of people without learning disabilities. For people with learning disabilities, this was a reduction from 15.5% of people being prescribed antipsychotics in 2017/18 (there was no change over time for people without learning disabilities). 

Fewer girls/women with learning disabilities were being prescribed antipsychotics (12.9% in 2024/25) than boys/men with learning disabilities (14.3% in 2024/25). 

In terms of age bands, the percentage of people with learning disabilities prescribed antipsychotics increases sharply from the age of 10 - from the ages of 25-34 years onwards, more than 10% of all people with learning disabilities in 2024/25 were being prescribed antipsychotics, peaking at 23.5% of people aged 65-74.

From 2020/21 onwards, the Health and Care dataset has added information on people being prescribed antipsychotics when they don't have a diagnosis of severe mental illness or palliative care needs. In 2024/25, 8.2% of people with learning disabilities (6.9% of girls/women; 9.1% of boys/men) without a severe mental illness diagnosis were still getting prescribed antipsychotics, compared to 0.4% of people without learning disabilities or a severe mental illness diagnosis. The percentage of people with learning disabilities prescribed antipsychotics in the absence of a diagnosis of severe mental illness has reduced over time, from 9.3% of people in 2020/21 to 8.2% in 2024/25.

These prescriptions in the absence of a severe mental illness diagnosis also rise steeply for people with learning disabilities from an early age - 10% of adults with learning disabilities without a diagnosis of severe mental illness are prescribed antipsychotics by the age of 25-34.

Taking into account differences in the populations of people with and without learning disabilities in things like age and sex, in 2024/25 being prescribed antipsychotics was 14 times more common among people with learning disabilities than you would expect from general population prescribing rates; for those without a diagnosis of severe mental illness this rose to being 18 times more common.

Depression and anti-depressants

The Health and Care dataset has very similar information about GP diagnosis of depression and the prescribing of anti-depressants.

Overall, the percentage of people with and without learning disabilities diagnosed with depression has increased over time, for people with learning disabilities (15.9% in 2024/25, up from 14.6% in 2020/21) and for people without learning disabilities (14.7% in 2024/25, up from 13.6% in 2020/21). Rates of diagnosed depression overall are higher for people with learning disabilities.

Amongst people with learning disabilities, girls/women were more likely to be diagnosed with depression (20.0% in 2024/25) than boys/men (13.2% in 2024/25). In terms of age bands, from the ages of 25-34 years onwards, more than 15% of people with learning disabilities had a diagnosis of depression, peaking at 25.5% of people aged 55-64.

Anti-depressants. Overall, in 2024/25, 22.4% of people with learning disabilities were being prescribed anti-depressants, compared to 11% of people without learning disabilities. Girls/women with learning disabilities were more likely to be prescribed anti-depressants (27.2% in 2024/25, compared to 14.6% of girls/women without learning disabilities) than boys/men with learning disabilities (19.4% in 2024/25, compared to 7.5% of boys/men without learning disabilities). 

In terms of age bands, from the ages of 18-24 years onwards, more than 15% of people with learning disabilities were being prescribed anti-depressants, peaking at 34% of people aged 55-64.

The Health and Care dataset has also been reporting on people being prescribed anti-depressants when they don't have a diagnosis of depression. In 2024/25, 12.4% of people with learning disabilities without a diagnosis of depression were being prescribed anti-depressants, compared to 4.4% of people without learning disabilities or a diagnosis of depression. For both groups, this had increased slightly since 2020/21 (11.6% of people with learning disabilities without a diagnosis of depression; 4.3% of people without learning disabilities or a diagnosis of depression). Again, this was more common for women with learning disabilities without a diagnosis of depression (13.7% in 2024/25) than men (11.5%). 

In terms of age bands, from the ages of 18-24 years onwards, more than 10% of people with learning disabilities but with no diagnosis of depression were being prescribed anti-depressants, peaking at 17.3% of people aged 65-74.

Taking into account differences in the populations of people with and without learning disabilities in things like age and sex, in 2024/25 being prescribed antidepressants was twice as common among people with learning disabilities than you would expect from general population prescribing rates; for those without a diagnosis of depression this rose to being 3 times more common.

Benzodiazepenes

Benzodiazepenes are a type of 'sedative' - they slow down the body and mind and are prescribed for acute anxiety or sleep problems, and it is recommended that they are not prescribed for more than four weeks at a time. The percentage of people with and without learning disabilities being prescribed benzodiazepenes is decreasing over time. In 2024/15, 6.1% of people with learning disabilities were being prescribed benzodiazepenes (down from 7.6% in 2017/18) compared to 1.4% of people without learning disabilities in 2024/25 (down from 2.4% in 2017/18). 

Amongst people with learning disabilities, in 2024/25 similar percentages of women with learning disabilities (6.4%) and men with learning disabilities (6%) were being prescribed benzodiazepenes.

In terms of age bands, more than 5% of people with learning disabilities from the age of 25 onwards were being prescribed benzodiazepenes.

Taking into account differences in the populations of people with and without learning disabilities in things like age and sex, in 2024/25 being prescribed benzodiazepenes was 5 times as common among people with learning disabilities than you would expect from general population prescribing rates. 

Conclusions

Many more people with learning disabilities than other people continue to be prescribed mental health medications, often without a relevant mental health diagnosis. Nearly 1 in 4 of all people with learning disabilities registered with GPs are on antidepressants, and 1 in 7 people with learning disabilities are on antipsychotics. 

While STOMP and STAMP initiatives might be having some impact on reducing the number of people being prescribed antipsychotics and benzodiazepenes, the increasing numbers of people being prescribed antidepressants is threatening to cancel out any of these gains. 

People with learning disabilities, compared to people without learning disabilities, are particularly likely to be prescribed mental health medications in the absence of a matching mental health diagnosis. This isn't news, but it doesn't stop it being a scandal.

There are also some big gender differences amongst people with learning disabilities, with little sign of these gaps closing over time. Women with learning disabilities are more likely to be prescribed antidepressants and than men with learning disabilities,  and it's the other way round for antipsychotics.

Significant numbers of people with learning disabilities are being prescribed these drugs at much earlier ages than people without learning disabilities (often in relatively early adulthood) for potentially longer periods of time. This is really worrying, given what we know about the side effects of many of these drugs over time, their addictive properties, and their potential impact on how they make people feel.

From the Health and Care dataset. we don't know how many people with learning disabilities are being prescribed more than one mental health drug, although a research project in Jersey suggested that almost a quarter (23%) of people with learning disabilities were being prescribed two or more mental health drugs. 

We also don't know any more how many people with learning disabilities in inpatient units are being prescribed these types of medications. 

The reductions in antipsychotic prescriptions show what can be achieved with concerted, consistent, targeted effort over many years, but also just how big the gap continues to be between people with and without learning disabilities. The increases in antidepressant prescriptions show what happens in the absence of such effort - for all the government talk about reducing health inequalities, the general way that societies and health services operate is taking existing horrendous inequities and making them worse.