We welcome the detailed response from Heslop et al giving more evidence in support of our recommendation for the effective use of reasonable adjustments during in-patient care. They also draw attention to the need for these to be properly audited by staff who understand the Equality Act 2010, which in our view would require an extensive educational programme, as there is no evidence that current audits are much more than a box-ticking exercise.

They repeat an earlier and often made recommendation that people with intellectual disabilities should be identified on a national NHS database. NHS England has already decided to set up a national learning-disability mortality review function, which will require a national database. Regrettably, this cannot commence until data linkages have been enabled by the NHS and the Health and Social Care Information Centre and it seems unlikely that this will be achieved until next summer. ¹ Strong advocacy is needed to ensure there are no further delays in giving priority to this work.