Umesh Chauhan

• Bachelor of Medicine
• Chair at University of Central Lancashire

Background Aggressive challenging behaviour is prevalent in adults with an intellectual disability and is associated with over-medication, physical ill-health and psychiatric hospitalisation. We urgently need interventions that can moderate this behaviour and improve quality of life in this population. We report on the development and modelling of...

Background: People with a learning disability from ethnic minorities experience barriers in their access to healthcare services and poorer health outcomes. This study aimed to explore the factors that contribute to these barriers and to better understand how they can be reduced. Methods: Twenty ‘experts by experience’ took part in experience‐based...

Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgical treatment method for aortic stenosis (AS) suitable for patients with varying levels of surgical risk and frailty. The number of TAVI procedures performed in the UK have increased exponentially in the last few years. TAVI outcomes are comparable to, or better in high-ris...

Background People with a learning disability face health inequality. Those from ethnic minority backgrounds with a learning disability face ‘double discrimination’ as members of two marginalised groups. Methods This codesigned review consolidated the evidence on the healthcare experiences of individuals and their carers from ethnic minority backgr...

Objective Intellectual disability liaison nurses in general hospitals could enhance access to high-quality, adapted healthcare and improve outcomes. We aimed to explore associations between the input of intellectual disability liaison nurses and the quality of care in people with intellectual disability who are admitted to hospital. Design Retrosp...

Background People with intellectual disabilities are more likely to be prescribed psychotropic medication than the general population and are frequently prescribed multiple medications. Understanding people with intellectual disabilities and carer perspectives is essential to improving the quality of psychotropic medication prescribing and usage....

Constipation is common in people with intellectual disability, with case reports of associated deaths. Risk factors include lifestyle factors, health conditions, and certain medications. We aimed to explore constipation in a sample of people with intellectual disability who died in 2021. We described prevalence of constipation, causes of death and...

People with a learning disability may be at a higher risk of developing bowel cancer due to the presence of certain risk factors, with an earlier age at onset. Currently in the UK everyone aged 60-74 is invited to take the Faecal Immunochemical Test (FIT) for bowel cancer screening every two years. This is being lowered to 55 in England and should...

Background Colorectal cancer is the second leading cause of cancer-related mortality in the United Kingdom and a significant contributor to morbidity and mortality worldwide. Early diagnosis provides opportunities for intervention and improved survival. Significant Event Analysis (SEA) is a well-established quality improvement method for learning f...

Intellectual disability (ID) is a lifelong neurodevelopmental condition involving deficits in both intellectual and adaptive functioning, with onset during the developmental period (from birth to 18 years of age). Individuals with ID experience a greater burden of co-occurring physical and mental illness compared to the general population, and freq...

Explores the link between constipation and prescribed medication in people with intellectual disability using data from an English national mortality programme.

Objectives Approximately 10% of people with intellectual disability display aggressive challenging behaviour, usually due to unmet needs. There are a variety of interventions available, yet a scarcity of understanding about what mechanisms contribute to successful interventions. We explored how complex interventions for aggressive challenging behav...

Objectives: Approximately 10% of people with intellectual disability display aggressive challenging behaviour, usually due to unmet needs. There are a variety of interventions available, yet a scarcity of understanding about what mechanisms contribute to successful interventions. We explored how complex interventions for aggressive challenging beha...

Background The deployment of (Trainee) Associate Psychological Practitioners (T/APPs) to deliver brief psychological interventions focusing on preventing mental health deterioration and promoting emotional wellbeing in General Practice settings is a novel development in the North West of England. As the need and demand for psychological practitione...

Background The minimal clinically important difference (MCID) is relevant in the estimation of improvement in a patient outcome. Aim To determine the MCID on the Aberrant Behaviour Checklist–Irritability (ABC-I), widely used to measure the effects of intervention for aggressive challenging behaviour in people with intellectual disabilities. Metho...

Description: ePoster abstract, as presented at UK Stroke Forum 2021 (UKSF2021); Presenter: Jo C. Weldon, Preston, United Kingdom; Authors: Josephine M. Gibson, Preston, United Kingdom; Jo C. Weldon, Preston, United Kingdom; Amitava Banerjee, London, United Kingdom; Umesh Chauhan, Preston, United Kingdom; Rachel Georgiou, Preston, United Kingdom; Mi...

Medical professionalism is an evolving entity, requiring continual development according to shifting societal priorities. The public trust that underpins the medical profession is imperative for maintaining effective partnerships with patients, their families and the wider community. This article provides an overview of what constitutes medical pro...

Scoping review protocol of universal school- and community- based resilience focused interventions with children and young people. The review aims to answer the following questions: • What is the scope of the evidence base for universally provided resilience-focused school- and community-based intervention in enhancing mental well-being of childr...

Background Obesity is higher in people with intellectual disabilities. Aims There are two aims of this explorative paper. Firstly, using a realist lens, to go beyond ‘what works’ and examine the ‘context, mechanisms and outcomes’ (CMO) of lifestyle/obesity programmes for this population. Second, using a logic model framework to inform how these pr...

Background GP satisfaction with specialist Child & Adolescent Mental Health Services (CAMHS) is often reported as low in the UK, and internationally. Aim To explore GP perceptions of local children’s mental health services and to understand their experiences of a novel GP-attached Primary Mental Health Worker (PMHW) service. Design & setting Qual...

Significant event analysis (SEA) is a structured quality improvement activity that is well established in general practice. Participation in SEA prompts primary care teams to reflect on their clinical reasoning, to highlight exemplary care, and to identify any potential improvements in both practice and wider healthcare systems. This article provid...

Background Globally, people with intellectual disabilities and/or autism experience health inequalities. Death occurs at a younger age and the prevalence of long-term morbidities is higher than in the general population. Despite this, their primary healthcare access rates are lower than the general population, their health needs are often unmet, an...

Background In many areas, new regional community-based services have been established to provide holistic care to patients with high physical, mental and social needs. Older people represent a group with multimorbidity and high healthcare needs that may benefit from holistic care, although uncertainty remains whether such an approach is effective....

Background and Purpose— Identifying the etiology of acute ischemic stroke is essential for effective secondary prevention. However, in at least one third of ischemic strokes, existing investigative protocols fail to determine the underlying cause. Establishing etiology is complicated by variation in clinical practice, often reflecting preferences o...

The aim of this chapter is to outline the importance of good physical health for a person with intellectual disability (ID) on their mental health and wellbeing; the impact of the choice of psychotropic therapy on their physical health; the presentations of mental disorders in people with ID with health problems; what to include in assessment—good...

Intellectual Disability (ID), a lifelong condition characterized by an impairment of intellectual functioning and deficits in adaptive skills is part of a spectrum of developmental disorders which also includes other conditions like autism and ADHD. While psychiatric problems are three to four times more common in those with ID, diagnosing it can b...

Background: Stroke is a leading cause of death and disability worldwide. Identifying the aetiology of ischaemic stroke is essential in order to initiate appropriate and timely secondary prevention measures to reduce the risk of recurrence. For the majority of ischaemic strokes, the aetiology can be readily identified, but in at least 30% of cases,...

Introduction: Patients with AF are at up to 6 times greater risk of stroke than those without.However, management of AF remains sub-optimal. Long-term oral anticoagulation with Warfarin is an effective treatment for reducing stroke risk in AF but its variable pharmacokinetic profile and narrow therapeutic range mean routine monitoring is required....

Background: Financial incentives in the UK such as the Quality and Outcomes Framework (QOF) reward GP surgeries for achievement of nationally defined targets. These have shown mixed results, with weak evidence for some measures, but also possible unintended negative effects. Aim: To look at the effects of a local intervention for atrial fibrilla...

Background Obesity is common in adults with intellectual disabilities, yet little is known about how weight management interventions are provided for this population. Methods Semi‐structured interviews were held with 14 healthcare practitioners involved in weight management interventions in an English county. A study topic guide was developed to...

Around a third of people will experience depression after having a stroke. Depression after stroke is associated with reduced quality of life, poorer medication compliance, and greater morbidity and mortality. It has historically been underdiagnosed and undertreated, despite recommendations that all individuals who have had a stroke be screened for...

Objective Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatment options have received little attention. The aim of this study was to identify and evaluate the effectiveness of pharmacological and psychological interventions in the treatment of mental health problems in children and adults wit...

Adults with intellectual disabilities in England experience health inequalities. They are more likely than their non-disabled peers to be obese and at risk of serious medical conditions such as heart disease, stroke and type 2 diabetes. This semi-qualitative study engaged adults with intellectual disabilities in a co-production process to explore t...

Background: Studies evaluating titration of antihypertensive medication using self-monitoring give contradictory findings and the precise place of telemonitoring over self-monitoring alone is unclear. The TASMINH4 trial aimed to assess the efficacy of self-monitored blood pressure, with or without telemonitoring, for antihypertensive titration in...

Accessible summary We gave a questionnaire to self‐advocates who were attending a conference. The questionnaire asked them how they felt about the information they get with their medicine. Fifty‐eight people completed the questionnaire. Many of them said they did not get enough information about their medicine. Most people wanted easy‐read leaflets...

Background Obesity is more prevalent in people with intellectual disabilities and increases the risk of developing serious medical conditions. UK guidance recommends multicomponent weight management interventions (MCIs), tailored for different population groups. Methods An integrative review utilizing systematic review methodology was conducted to...

People with intellectual disability have significantly worse health than those without, and have a higher level of complex health needs. The life expectancy for men and women is 13 and 20 years shorter, respectively, than the general population. The increasing role of general practice in delivering and coordinating care across health and social car...

Background: Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim: To assess the impact of providing patients with access to their general practice electronic healt...

Background People with intellectual disabilities (ID) have many comorbidities but experience inequities in access to health care. National Health Service England uses an opt-in incentive scheme to encourage annual health checks of patients with ID in primary care. We investigated whether the fi rst 3 years of the programme had improved health care...

Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. To assess the impact of providing patients with access to their general practice electronic health records (EHR) a...

Purpose The purpose of this paper is to introduce and present the first findings of a new English performance indicator in the primary healthcare of adults with Down syndrome. This is a performance target, with associated bonus payment, requiring General Practitioners (GPs) to undertake annually a screening blood test for thyroid hormone deficiency...

Purpose – The purpose of this paper is to introduce and present the first findings of a new English performance indicator in the primary healthcare of adults with Down syndrome. This is a performance target, with associated bonus payment, requiring General Practitioners (GPs) to undertake annually a screening blood test for thyroid hormone deficien...

Potentially an important step towards reducing health inequalities The recent convictions in the United Kingdom of 11 staff members from Winterbourne View Hospital of the criminal charges of abuse of adults with intellectual disabilities highlights the continued institutional weaknesses in caring for this vulnerable group.1 However, most people wi...

Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, a...

While practice-level or team accreditation is not new to primary care in the UK and there are organisational indicators in the Quality and Outcomes Framework (QOF) organisational domain, there is no universal system of accreditation of the quality of organisational aspects of care in the UK. To describe the development, content and piloting of vers...

Background: Routine health checks have gained prominence as a way of detecting unmet need in primary care for adults with intellectual disabilities (ID) and general practitioners are being incentivised in the UK to carry out health checks for many conditions through an incentivisation scheme known as the Quality and Outcomes Framework (QOF). Howev...

In the United Kingdom (UK) ethnic minority groups from the Indian sub-continent (India, Pakistan and Bangladesh) are at increased risk of coronary heart disease (CHD) related mortality and morbidity. The aim of this study was to assess the variation in recording of clinical data by ethnicity following the implementation of an electronic centralised...

In the United Kingdom ethnic minority groups from the Indian sub-continent (India, Pakistan and Bangladesh) are at increased risk of coronary heart disease related mortality and morbidity. Variation in prevalence and outcome is in part related to access to appropriate health care. This study explores the experiences of participants following an acu...

Since the publication of the National Service Framework for coronary heart disease, there has been a move towards primary disease prevention with a greater focus on an individual's absolute risk. Meta-analysis and systematic reviews of the evidence for primary prevention are incomplete and the current guidelines and policy have led to considerable...