More and better services for people with learning disabilities.

A prevalence study of disability, use of and need for services was undertaken to estimate the need for NHS and other forms of residential, day and respite care for people with severe learning disabilities. Subjects aged 20 or more were drawn from the Leicestershire Learning Disabilities Register (n = 1887). Information was collected by interview with a professional career. The age-specific prevalence was 2.9 per 1000 and the response rate was 88 per cent. A disability rating predicted consultant opinion on need for NHS residential care with a sensitivity and specificity of 82 per cent. Predictive disability factors included problems with behaviour, toileting, speech, epilepsy, postural deformity and use of a wheelchair. Planning targets per 100,000 population aged 20 or more were estimated as follows: NHS residential care--47 places; other residential care--103 places; respite care--36 people; day care--224 places. The need for residential care and medical support remains eminently predictable within the new philosophical framework of provision. Since 1971 the need for NHS residential places has decreased but remains important for people with high dependence. Day care targets have increased and diversified.