Health & wellbeing
What a learning disability is
In England the definition that carries rights is written for disability rather than for learning disability: under the Equality Act 2010, a person has a disability if an impairment has a substantial and long-term adverse effect on normal day-to-day activities. The NHS works from a second, practical list, the GP learning disability register, and it is the register that opens the annual health check.
Last checked on 3 September 2026
What does the law actually define?
The statute that carries the duty to make adjustments defines disability, and it does so in two limbs that both have to be satisfied. Section 6 of the Equality Act 2010 provides that a person has a disability if the person has a physical or mental impairment, and the impairment has a substantial and long-term adverse effect on the person's ability to carry out normal day-to-day activities. Both words are doing work: substantial and long-term are the parts that separate a condition that shapes a life from one that passes, and normal day-to-day activities is the part that makes the test about ordinary life rather than about a diagnosis.
Equality Act 2010, section 6, Disability. Version Latest available (Revised), legislation.gov.uk, read on 3 September 2026.
That is the definition this handbook quotes in full, because it is short and because a paraphrase of a legal test is how a reader ends up being told by a page that they do not qualify, by an author with no standing to say so. What the definition leads to is a duty: the NHS page on annual health checks states it in one line, that the NHS has to make it as easy for disabled people to use health services as it is for people who are not disabled, and calls that making reasonable adjustments. The statute defines who is covered, and the service states what it then has to do.
NHS, annual health checks for people with a learning disability, page reviewed 24 September 2025, read on 3 September 2026.
Who decides who is on the register?
The GP practice records it. The NHS page says a person can ask to go on the register if they think they have a learning disability, and the yearly statistics count the result: patients recorded by their GP as having a learning disability. In 2024-25 that came to 0.55 per cent of registered patients, against 0.54 per cent in 2023-24. The register is therefore a list built practice by practice from people who have been recorded, which is why it is described here as a practical definition: it is the list that decides who is offered the check, whatever else any document says.
NHS, annual health checks for people with a learning disability, page reviewed 24 September 2025, read on 3 September 2026.
Health and Care of People with Learning Disabilities, 2024-25, NHS England, published 4 December 2025, read on 3 September 2026.
What do the yearly figures count?
The same register, seen from above. Health and Care of People with Learning Disabilities, published by NHS England on 4 December 2025, compares people recorded by their GP as having a learning disability with a comparison group recorded without one. That is why its percentages measure the register and its use, and why a percentage from it should always travel with the year it covers and the year before.
Health and Care of People with Learning Disabilities, 2024-25, NHS England, published 4 December 2025, read on 3 September 2026.
The publication also counts autism separately, which is the clearest statement it makes about vocabulary without using any. In 2024-25, 35.3 per cent of patients with a learning disability also had a diagnosis of autism, against 33.3 per cent in 2023-24 and 21.4 per cent in 2017-18. Two entries that can be recorded about the same person, and are counted apart, are two entries: autism is recorded as its own thing, and the overlap is a measurement rather than a definition.
Health and Care of People with Learning Disabilities, 2024-25, NHS England, published 4 December 2025, read on 3 September 2026.
Where does the phrase learning difficulty fit?
Not on the sources this page was written from. The NHS page that carries the annual health check uses learning disability throughout and never uses the phrase learning difficulty; the Equality Act defines disability and stops there; the statistics record learning disability and record autism as a separate entry. Three primary sources, one vocabulary, and no occurrence of the second phrase in any of them.
NHS, annual health checks for people with a learning disability, page reviewed 24 September 2025, read on 3 September 2026.
Equality Act 2010, section 6, Disability. Version Latest available (Revised), legislation.gov.uk, read on 3 September 2026.
The practical consequence is a question worth asking rather than a point worth arguing. When a letter, a form or a conversation uses a different phrase, the thing to ask is which definition the writer is applying, because each definition in England opens a different door: the register opens the annual health check, the Equality Act definition carries the duty to adjust, and a needs assessment under the Care Act 2014 runs on its own questions, set out under your rights under the law.
Why does the difference matter?
Because the doors are separate. Being on the register is what brings the yearly appointment from the age of 14, which the annual health check follows step by step. Meeting the Equality Act definition is what carries the duty to make adjustments wherever care is provided. Neither automatically brings the other, and a person can be described in a letter in a way that reaches neither, which is the expensive outcome this page exists to prevent.
One further distinction keeps the vocabulary honest. Whether a person can make a particular decision is a separate question, governed by the Mental Capacity Act 2005, and it is asked decision by decision rather than settled once about a person. This page names that Act and stops there: its revised text on legislation.gov.uk was read for this page, and the sections that carry the presumption and the assessments are printed, with their numbers, on the pages of this handbook that turn on them.
Mental Capacity Act 2005, revised text on legislation.gov.uk, read on 3 September 2026.
The same vocabulary is where the care workforce starts: working in care is written from the obligations that follow an organisation once it supports adults, and the distinction between a disability and a difficulty is the first thing its pages rely on. The wider section around this page is health and wellbeing, which holds the register, the check and the December figures together.
Where do these words get re-read?
Annually, in the case of the statistics, which is when a movement in a percentage is worth reading as a change in the register rather than in the population. dated notes records each new edition with the date its source was opened, so that a term quoted on this page can be checked against the document it came from at the time it was quoted.
What this page is
This page explains what the sources define and what they count. It is not an assessment of any person, and nothing on it decides how a word applies to an individual. It describes England; the other countries of the United Kingdom use their own terms and their own law.
Sources read for this page
- NHS, annual health checks for people with a learning disability, page reviewed 24 September 2025
- Health and Care of People with Learning Disabilities, 2024-25, NHS England, published 4 December 2025
- Mental Capacity Act 2005, revised text on legislation.gov.uk
- Equality Act 2010, revised text on legislation.gov.uk
Each source above was opened on 3 September 2026. Where a page here prints a section number or a figure, the source line beside it names the version that number was read from.