Development and Implementation of an Anticipatory Care Calendar for people with learning disabilities or dementia


The Anticipatory Care Calendar (ACC) is a simple tool to improve daily surveillance of health. It overcomes barriers that can prevent people with learning disabilities and dementia accessing health services. The ACC is designed to alert staff to health changes and prompts appropriate access to primary care.  

People living with a learning disability have spent decades being excluded from mainstream society and remain almost invisible in our communities, workplaces and in family life. As a result, the health of people with a learning disability or dementia is significantly poorer than that of the general population.  

This ACC tool maps changes and patterns relating to health and behaviour over a whole month. ACC helps healthcare professionals to see the relationship between health domains such as pain, eating, drinking, elimination, sleeping, etc, rather than one health issue or behaviour in isolation. The tool prompts staff to act on changes and helps them to visualise changes overtime. 

The tool is sustainable and is supported by a website and an educational package facilitated by Edge Hill University.


Despite the many reports and policy recommendations, little has been done to address the social exclusion of these groups, and their health and wellbeing continues to decline.

We have explored this topic extensively with national bodies such as the National Cancer Action Team, Department of Health, Equality and Human Rights Commission, Care Quality Commission, The National Autistic Society as well as learning disability leads throughout the North West.

The conclusion of this engagement has been to suggest that there are no other solutions of this type or effectiveness.


  1. To develop robust care pathways that lead to action following health triggers that require prompt attention.
  2. To produce a sound clinical governance and critical care review mechanism.
  3. To accurately record and improve the attendance for National Screening Programmes
  4. To improve communication between the multi-disciplinary teams in the NHS & Social Care
  5. To assist in identifying underlying health issues, that maybe considered a behavioural problem
  6. To provide a visual picture of a client’s health status on a daily basis when there is no capacity for the client to express themselves
  7. Ensure sustainability
  8. Develop an educational tool.

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QiC Oncology Winner 2012
Reducing cancer inequality initiative
Development and implementation of an anticipatory care calendar for people with learning disabilities or dementia
by Cheshire and Merseyside Clinical Networks, Merseyside and Cheshire Cancer Network


ACC article 2010 - 317.8 KB
ACC Brochure - 1.6 MB
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