With primary care trusts being handed responsibility for commissioning healthcare services for 34 prisons in England and Wales, fundamental changes are in the offing. Victoria Herrington and colleagues describe how one PCT dealt with the challenge

It is widely recognised that many individuals with learning disabilities have additional health problems. For example, they are more likely to experience vision and hearing difficulties, to have physical disabilities, and chronic health problems such as epilepsy and thyroid conditions (Emerson et al 2001, Mencap 2004). They are three times more likely to die from respiratory disease (Hollins et al 1998), and have a higher rate of coronary heart disease and some forms of cancer (Duff et al 2001, Mencap 2004). They are also more likely to suffer from weight problems (Mencap 2004).