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Models of Service Development and Delivery for People with Intellectual Disability

It is important to ensure that people with intellectual disability (ID) have access to high quality healthcare services. There is a wide variation in the availability of services and service delivery models globally for people with ID. Reasons for these variations are examined including availability of workforce resources and the development and availability of specialist resources. Tracing the development of services across the world, the chapter goes on to review the ongoing debate on access to generalized healthcare services versus the role of specialist services. We review advantages and disadvantages of different service delivery models. While these models have evolved in response to the political, cultural, and economic environment, it is important that any development of service delivery model signs up to basic underlying principles of person-centred, right-based, and outcome-focused approach. This should be undertaken in partnership with service users and carers in the spirit of co-production and with the underlying principles of choice, inclusion, rights, and independence. Any service development should also ensure that it would meet the complex health needs of people with ID as described in the tiered model of services with an efficient use of available resources. It should be sustainable through development of skills, competencies, and capabilities of the workforce and agencies that work with people with ID. There are number of examples across countries of innovative service provisions by public, private, and voluntary sectors as described in the chapter and it is important that we learn from those models. Advocating should be an integral aspect of any service delivery; we should be constantly advocating globally for high quality healthcare based on the best available evidence for people with ID.