The Covid-19 pandemic highlighted longstanding inequalities faced by people with learning disabilities in the United Kingdom, according to a new report examining their treatment during the health crisis. An estimated 1.5 million individuals with learning disabilities in the UK experienced significantly higher risks during the pandemic, with mortality rates in England reported to be four to six times greater than the general population.

Tona Walker, who has a learning disability, described the heightened fear she experienced as Covid-related deaths climbed, expressing concern that her life might not have been equally valued in healthcare decision-making. The pandemic, the report emphasizes, did not create these disparities but exposed and intensified pre-existing vulnerabilities. People with learning disabilities already face an average life expectancy nearly 20 years shorter than those without such conditions, and their deaths are more frequently classified as avoidable.

The report, titled How We Survive and Thrive, was commissioned by Learning Disability England in collaboration with researchers from the University of Birmingham and Manchester Metropolitan University. It highlights how families and carers felt abandoned by healthcare planners during the pandemic, despite the critical support provided by carers and community networks. The needs of those living outside care homes—such as in family residences or community settings—were often neglected.

Among the key recommendations are measures to prioritise patients with learning disabilities in future health emergencies and to ensure support services are expanded rather than reduced. The report also calls for more consistent inclusion of individuals in the GP learning disability register, provision of accessible information, and implementation of reasonable adjustments to care delivery. It stresses that behaviors sometimes interpreted as refusals of treatment often reflect challenges in communication, underscoring the necessity for caregivers or advocates to be present to facilitate understanding. Organizations such as Mencap have underscored that such adjustments may be critical for patient survival.

The report points to systemic issues within the healthcare system, noting that despite dedicated efforts by many carers and healthcare professionals, societal prejudices persist. Early in the pandemic, the inappropriate widespread use of “do not attempt cardiopulmonary resuscitation” (DNACPR) orders for people with learning disabilities raised concerns. Initial guidance from the National Institute for Health and Care Excellence (NICE) recommended assessing patients’ frailty scores, which could disadvantage those needing personal care regardless of the underlying reason. This guidance was later withdrawn. Testimonies from affected individuals and families suggest that assumptions about quality of life contributed to these troubling practices, highlighting the need for sustained training and enforced accountability to combat bias.

The report also voices concern that progress achieved in recent decades may be at risk. Cuts to social care packages and local support services have compounded existing challenges in healthcare provision. Important programs, such as the Learning from Lives and Deaths scheme—which investigates care prior to the deaths of people with learning disabilities and autism—and mandatory training for healthcare staff, face increasing financial pressure. Additionally, the workforce trained to support this population is shrinking, with the number of learning-disability nurses declining by one-third since 2009 and student enrolments plummeting.

Advocates and researchers alike stress that these trends must be reversed to ensure that learning disabilities no longer result in diminished life expectancy, emphasizing that equitable healthcare and support remain urgent priorities.