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Home » Training & Assessment » Curriculum » Clinical Chapters » Care of People with Disabilities

Care of People with Disabilities

Care of People with Disabilities (DI)

  • Providing high-quality care for people with disabilities is a fundamental aspect of inclusive, person-centred general practice. People living with physical, sensory, intellectual, or developmental disabilities may face a range of barriers to accessing healthcare, including communication challenges, mobility issues, social stigma, and systemic inequalities. GPs have a key role in ensuring that healthcare is accessible, respectful, and responsive to the diverse needs of individuals with disabilities across the lifespan. This includes preventive care, the management of chronic health conditions, support for mental health and well-being, and advocacy for social inclusion and access to services. Delivering effective care requires strong communication skills, sensitivity to individual needs and collaboration with families, carers, and multidisciplinary teams.  

    • DI1. Provide inclusive, patient-centred care that addresses the unique needs of individuals with disabilities, ensuring effective communication and respect for autonomy.
    • DI2. Demonstrate a commitment to inclusive and respectful care, challenging negative attitudes, promoting equal opportunities, and advocating for the rights of individuals with disabilities.
    • DI3. Demonstrate an understanding of the critical role of early and ongoing psychosocial support for families/ caregivers of children with disabilities and complex needs, with particular emphasis on the primary caregiver(s).
    • DI4. Identify and advocate for appropriate supports for the whole family/carers eg signposting to appropriate third sector supports, including siblings, in recognition of the broader impact of disability within the family unit.
    • DI5. Demonstrate an understanding of key social protection supports/ financial supports available to families of children with disabilities and complex needs and the importance of timely signposting and assistance with applications.
    • DI6. Manage common physical disabilities and understand their associated health conditions and complications.
    • DI7. Manage common issues associated with physical disabilities.
    • DI8. Recognise and critically reflect on the concept of diagnostic overshadowing, where physical or mental health symptoms may be misattributed to a person’s existing disability or diagnosis.
    • DI9. Recognise that patients with disabilities or their carers have the expert and valuable experience that should be incorporated where possible.
    • DI10. Understand and apply legal and ethical principles when providing care for individuals with disabilities, including the Assisted Decision-Making (Capacity) Act (2015), consent, and equality legislation.
    • DI11. Create an inclusive and accessible general practice environment that meets the physical and communication needs of individuals with disabilities.
    • DI12. Provide inclusive and equitable care for patients with intellectual disabilities by addressing environmental barriers, challenging discrimination, and advocating for their needs.
    • DI13. Recognise that a significant proportion of any practice population may have mild intellectual disabilities, requiring no specialist services but potentially experiencing difficulties with reading, writing, and comprehension and provide appropriate support.
    • DI14. Provide person-centred care that meets the unique needs of patients with intellectual disabilities, ensuring continuity of care and recognising associated conditions.
    • DI15. Recognise the GP’s role in safeguarding vulnerable persons at risk of abuse, ensuring early identification and intervention to prevent escalation, onward appropriate referral and appropriate response to concerns.
    • DI16. Support adolescents with learning disabilities as they transition into adulthood, addressing their evolving healthcare needs and recognising the challenges faced by their families.
    • DI17. Recognise and manage autistic spectrum conditions and neurodiverse conditions, ensuring appropriate diagnosis, support, and coordination of care.

    For each problem or disease, consider the following areas within the general context of primary care:  

    • The natural history of the condition, including whether acute or chronic
    • The incidence and prevalence, including in different demographic groups
    • Typical and atypical presentations
    • Recognition of normal variations throughout life
    • Risk factors, including lifestyle, socio-economic and genetic factors
    • Diagnostic features and differential diagnosis
    • Recognition of ‘alarm’ or ‘red flag’ features
    • Appropriate and relevant investigations
    • Interpretation of test results
    • Management, including initial and continuing care, chronic disease monitoring and emergency care
    • Patient and carer information and education
    • Prognosis

    Symptoms, Signs and Presentations

    • Anxiety or depression
    • Carer stress or burnout
    • Changes in hearing or vision (often gradual and under-recognised)
    • Changes in mobility, balance, or increased falls
    • Contractures or joint deformities
    • Fatigue or low energy
    • Frequent infections
    • Gastrointestinal symptoms
    • Low mood, loss of interest in activities
    • Missed preventive health measures (e.g., vaccinations, screening programmes)
    • New or worsening spasticity or weakness
    • Nutritional problems
    • Polypharmacy and medication side effects
    • Atypical responsiveness to environmental stimuli
    • Poor wound healing
    • Poorly controlled diabetes, hypertension, or epilepsy
    • Pressure sores or skin breakdown
    • Regression in communication skills or non-verbal cues of distress
    • Seizures
    • Sleep disturbances
    • Social isolation and loneliness
    • Unexplained changes in behaviour (may signal pain, infection, or emotional distress)
    • Withdrawal, agitation, or aggression

    Common and Important Conditions

    • Anxiety and depression
    • Attention Deficit Hyperactivity Disorder ADHD
    • Autism spectrum disorder (ASD)
    • Cerebral palsy
    • Constipation and gastrointestinal dysfunction
    • Down syndrome
    • Early-onset dementia
    • Epilepsy
    • Foetal Alcohol Spectrum Disorder
    • Fragile X syndrome
    • Friedrichs Ataxia
    • Gastroesophageal reflux disease (GORD)
    • Hearing loss
    • Intellectual disability
    • Joint contractures and deformities
    • Limb Amputation
    • Muscular dystrophies
    • Obesity and metabolic syndrome
    • Osteoporosis and fractures
    • Polio
    • Post Polio Syndrome
    • Pressure ulcers
    • Respiratory complications (aspiration pneumonia, restrictive lung disease)
    • Rett syndrome
    • Spina bifida
    • Spinal cord injury
    • Stroke
    • Traumatic brain injury
    • Urinary tract infections
    • Visual impairment

  • Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

    Self-Directed 

    Workplace Based Learning

    Workplace-based learning offers vital opportunities to develop the skills needed to deliver effective, person-centred care to people with disabilities. In general practice and hospital settings, trainees encounter patients with a wide range of physical, sensory, intellectual, and developmental disabilities, each with unique health needs. Real-world clinical encounters allow trainees to refine their communication skills, adapting consultations to overcome barriers related to speech, cognition, or mobility. Managing common health issues such as epilepsy, pressure ulcers, constipation, and mental health conditions in this population reinforces the importance of holistic, anticipatory care. Trainees also learn the value of working collaboratively with families, carers, and multidisciplinary teams to support preventive health, chronic disease management, and safeguarding. Observing how experienced clinicians advocate for reasonable adjustments and promote equitable access to care helps to build a proactive, inclusive approach that respects the dignity and autonomy of every patient.

    Day Release

    Day release sessions provide a valuable opportunity to explore the principles of inclusive healthcare for people with disabilities in a collaborative, reflective environment. Through case-based discussions, trainees can deepen their understanding of the diverse health needs of individuals with physical, sensory, intellectual, and developmental disabilities. Sessions can focus on adapting communication strategies, addressing health inequalities, safeguarding vulnerable patients, and supporting carers. Practical workshops might also include discussions on health screening adaptations, navigating consent and capacity issues, or planning holistic chronic disease management. Sharing experiences from different practices allows trainees to reflect on the challenges and best practices for delivering accessible, person-centred care, while reinforcing the importance of promoting autonomy, dignity, and equitable healthcare access.

    Registrar Tutorials

    Registrar tutorials offer a focused space to apply knowledge about the care of people with disabilities to real-world clinical practice. Using recent patient encounters, trainees and trainers can work through complex cases involving communication difficulties, management of comorbidities, safeguarding concerns, or ethical issues around consent and decision-making. Tutorials can also be used to review local and national resources and discuss strategies for coordinating care with multidisciplinary teams. Reflecting on these consultations helps trainees develop a confident, empathetic, and proactive approach to supporting patients with disabilities and their families, ensuring that care is not only clinically appropriate but also equitable and inclusive.

  • Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

    The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

    The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

     EPA 13: Patient Advocacy

    For EPA 13, supporting a parent to access financial entitlements and respite services for a child with complex needs demonstrates advocacy and coordination of care. A CBD can be used to review knowledge of social protection supports, signposting to charities, and sensitive engagement with the wider family unit.

    Core Knowledge Test (CKT)

    • Selecting the most appropriate consultation adjustment for a patient with severe hearing impairment attending for a medication review.
    • Knowing how to ensure the practice premises is accessible to patients with physical disabilities
    • Identifying the most appropriate consent process for a procedure in an adult with moderate learning disability who has a supportive family carer.

    Clinical Competency Test (CCT)

    • A patient with learning disabilities attends for review.
    • A carer attends with concerns about behavioural changes in an adult with autistic spectrum disorder.
    • A patient attends to request a disability parking permit.

    Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

    Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

    The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

    Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.