Reviewed by Lasarina Maguire, Senior Nurse Manager, Stewarts Hospital Services


This independent study pack is designed for frontline staff working directly with people with a learning disability. The course has been produced to support individual study, organisational training and established BILD distance learning courses. It is linked to an accreditation system validated by BILD.

The pack comprises six stand-along study units which, when studied in sequence, provide a spiral approach to the topic. An overview of the course is provided in Unit 1. The learning outcomes for each of the units are clearly stated. The liberal use of activities and the inclusion of helpful points for practice make the units easy to follow.

Unit 1 (Introduction to health care) introduces the concept of health and considers why people with a learning disability need support in this particular area. An overview of the National Health Service and the role that staff play in health-care delivery is offered. (For Irish usage, this might be substituted by an overview of health care in the Irish context.)

Unit 2 (Finding out about illness) considers topics such as health surveillance, illness, seeking medical advice and health promotion. The unit focuses on the craft of physical care with persons with a learning disability, with emphasis on the need for ongoing observation. The fact is reinforced that every interaction with a client provides an opportunity to monitor their health-care status. The importance of communication underpinning interactions with and on behalf of clients permeates the unit.

Unit 3 (Improving health promotion and health care for people with a learning disability) presents a comprehensive overview of the treatment and care of people who present with a medical illness. Notably, the unit considers issues of consent, support for people with a chronic or terminal illness, bereavement and preparation for death. The topics are addressed in a caring and sensitive manner.

Unit 4 (Health promotion) expands on the concept of health care which was introduced in the first unit, with the central theme of the relationship between lifestyle and health Topics include physical, mental and sexual health, employment, exercise, drugs, sun exposure and friendships. Underpinning the text is the importance of the carer’s role in enabling clients to make informed choices to improve their quality of life.

Unit 5 (Overcoming inequalities in health care) highlights the rights of a person with a learning disability to good-quality health care. Issues raised in previous sections are set within the context of individual right.

Unit 6 (Ill health and learning disability), the final section, addresses an eclectic range of topics, including the direct and indirect effects of learning disability and health needs and the carer’s roles in helping clients who experience ill health as a consequence of their learning disability. Sub-sections concentrate on the main health needs of people with Down Syndrome, the difference between mental illness and mental health, epilepsy and dementia. Although detailed consideration is not possible, given the wide range of topics, coverage suffices for a basic level.

Overall, this study pack provides a comprehensive and very readable introduction to the issues pertaining to better health and people with a learning disability, for unqualified staff. The layout is logical and appealing. The user-friendly text is systematic and provides a basic grounding in key skills. The units encourage students to reflect and build on their own experience. Furthermore, the activities and points for practice support the application of learning. The package reflects recent developments and trends in health care which impact on the quality of life for persons with a learning disability. The quality of the material is impressive. The writing style is accessible and any jargon is explained. In conclusion, this pack would be of great value both to individual students and as a resource for in-service education and training.

BETTER HEALTH: Improving health promotion and health care for people with a learning disability by John Harris, Neil Simpson and Jackie Rodgers. BILD, Kidderminster (2000). ISBN 1 902519 22 1 (First Draft Publications Series) Stg£50-00 for the set, plus 5% p&p.