Abstract
The evidence suggests that the current delivery of primary care to people with a learning disability does not adequately meet their needs. In particular, individuals do not access adequate health promotion, are not having treatable illnesses identified and are not having more complex needs addressed. This review examines this evidence, highlights barriers to the effective delivery of health care and assesses these barriers, pilot projects and the few intervention studies published. Effective response to health needs will need a change in the working patterns of primary, secondary and social care providers. The contracting system and the move to locality-based purchasing may be the ideal catalysts for these changes.