Problems getting appointments with a GP are common for many, but it can be even harder for those with learning disabilities, a review has found. Hywel Dda Community Health Council (CHC) – the patient watchdog – teamed up with Pembrokeshire People First to find out about the experiences people have accessing health services. At an event in March people from across Carmarthenshire, Ceredigion and Pembrokeshire came together to help capture views and look closer at what caused them. Carers of people with learning difficulties also took part. There was a range of positive responses about NHS experiences and it was noted that Hywel Dda Health Board should encourage feedback and “learn from what works well.” “Good experiences aren’t just a ‘nice’ outcome, they are crucial to helping people become more confident in using NHS services,” adds the report. Accessing GP services – often the first port of call for many people – has been getting harder across Hywel Dda with many practices struggling to meet demand, often due to  staff shortages. New systems limiting appointments or ways of managing queues can be difficult for some. The CHC report states: “One person told us that by the time a carer or support worker was able to call for an appointment on their behalf, appointments had been taken for the day.” It asks that more be done to ensure GP practices “understand the potential impact for people with a learning disability and the challenges they might face.” Proposed changes to existing health services was “one of the most striking issue” talked about with strong feelings that what people were used to would change. This made a number of those involved “unsettled and worried” and people were worried about safety without access to emergency care. Transport and travel was also high on the agenda with more options needed and a review of current provision advised. A carer highlighted concerns about people with learning difficulties not receiving  health checks and screenings they are entitled to, including the Welsh annual health check which was introduced in 2006. According to the report not enough people were receiving this service, provided by GPs, and this needed to be reviewed. Other changes needed related to communication and some described bad experiences, such as being talked over, not listened to, difficulties with phoning for appointments or using automated telephone menus and understanding prescriptions. CHC’s across Wales highlight communication as a key area of improvement and problems with it feature in a large number of complaints, and this is made worse for those with learning difficulties. Continuity of care and being able to build a relationship with staff is important as well as more understanding of learning difficulties from NHS staff was also highlighted by the report. Solutions to some of the issues highlighted include training, making more use of volunteers as well as using existing services to their full potential.