Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of diagnostic overshadowing on people with Down syndrome; and if he will take steps to include expectations on condition-specific training for relevant professionals within guidance under the Down Syndrome Act 2022.

In 2023, NHS England produced a guide for frontline staff as they support people with a learning disability which asks staff to be aware of diagnostic overshadowing, and which is available at the following link:

https://www.england.nhs.uk/long-read/clinical-guide-for-front-line-staff-to-support-the-management-of-patients-with-a-learning-disability-and-autistic-people-relevant-to-all-clinical-specialties/

NHS England does not hold data on the extent of diagnostic overshadowing for people with Down syndrome, nor is the data held centrally.

Through the implementation of the Down Syndrome Act 2022, the Government is striving to improve life outcomes for people with Down syndrome, raise awareness and understanding of their needs, and break down barriers to opportunity that they, and other disabled people, face.

Under the Down Syndrome Act, my Rt Hon. Friend, the Secretary of State for Health and Social Care, is required to give guidance to relevant authorities in health, social care, education, and housing services on what they should be doing to support the needs of people with Down syndrome. The draft guidance, which was published for public consultation on 5 November 2025, acknowledges that the care of people with Down syndrome may be affected by diagnostic overshadowing and recognises its impact on the care and treatment that people receive. Once the consultation has closed on 30 March 2026, the Government will consider all consultation responses to inform the final guidance to be published.

Relevant authorities, as defined in the schedule to the act, have a duty to have due regard to the final guidance once it is published. The act does not create any new functions beyond this duty. Rather, it brings together existing statutory requirements and guidance that relevant authorities must and/or should already be complying with to support people with Down syndrome and people with other conditions and/or a learning disability who have similar needs.

Under existing legislation, Care Quality Comision registered providers must ensure that staff receive appropriate professional development which is necessary for them to carry out their duties and must receive specific training on learning disability and autism appropriate to their role, as per Section 20 of the Health and Social Care Act 2008, Section 181(7) of the Health and Care Act 2022 and Regulation 18 of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014. We expect that providers should be considering whether specific training on Down syndrome is required for their staff, and the draft guidance under the Down Syndrome Act sets out that some staff who work frequently with people with Down syndrome may require additional training on Down syndrome.