It is widely recognised that many individuals with learning disabilities have additional health problems. For example, they are more likely to experience vision and hearing difficulties, to have physical disabilities, and chronic health problems such as epilepsy and thyroid conditions (Emerson et al 2001, Mencap 2004). They are three times more likely to die from respiratory disease (Hollins et al 1998), and have a higher rate of coronary heart disease and some forms of cancer (Duff et al 2001, Mencap 2004). They are also more likely to suffer from weight problems (Mencap 2004). Mental health problems, particularly dementia and schizophrenia, are over-represented within this group (Cooper 1997, Iverson and Fox 1989, Reid 1994), and individuals with learning disability are much more likely to die before the age of 50 than those without learning disabilities (Mencap 2004). Such problems are exacerbated by a reduced use of general practice surgeries or preventive screening and health promotion measures by this group (Davies and Duff 2001, Wilson and Haire 1990). Even among those who are registered with a GP, health screening reveals a high level of unmet health need. A further issue is that many healthcare professionals lack understanding of people with a learning disability (Mencap 2004). Such evidence of healthcare need raises a number of questions for PCTs that have responsibility for providing health care to prisoners. For example:■ What is known about the prevalence of