<p>Since the inception of community care for people with learning disabilities in the early 1980s, considerable concern has been expressed about the poor state of their health, and the poor uptake of health care services (Matthews et al 2002, Meehan et al 1995). The Department of Health (DH) has highlighted the situation and attempted to provide solutions to resolve the problems with a series of reports, including Signposts for Success (NHS Executive 1998a), Once a Day (NHS Executive 1998b), Valuing People (DH 2001) and Action for Health (DH 2002). But Signposts for Success seems to have had little impact, and Once a Day has generally been ignored by healthcare providers. Earlier in 2005, the Disability Rights Commission commenced an ongoing formal investigation to help resolve the same issue.</p>