The goal of the commission, launched in March 2005, is to strengthen health equity by catalysing policy and institutional change to address the social determinants of health.

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This paper reports the results of the largest survey to date of the sexual abuse of adults with learning disabilities. Existing knowledge is reviewed in the light of complex methodological and definition issues that exist and limit any work undertaken. The few existing studies of sexual abuse of adults with learning disabilities are described. Details of the current survey of sexual abuse carried out by the University of Kent and funded by the Rowntree Foundation are then provided. Detailed results of the survey are presented followed by a discussion of their implications and comparability with previous research. 0952-9608/93/03 0193 -24 $1.80/0 MENTAL HANDICAP RESEARCH 0

This paper reports the results of the second part of the largest UK incidence survey to date of the sexual abuse of adults with learning disabilities. A mandate was sought from the relevant statutory agencies and a standard questionnaire filled in by service managers or practitioners for each casehncident reported which fitted the definitions and parameters of the survey. The results confirm the pattern of abuse which emerged from the earlier study, i.e. that both women and men are at risk, that perpetrators are predominantly men and usually known rather than strangers. One important difference was a significant increase in the proportion of cases, of abuse of men with learning disabilities reported. Despite the increase in awareness and sources of information about adult abuse, service agencies have not developed coordinated systems for reporting or recording instances of sexual abuse. Data collection continues to be patchy and ad hoc. The level of reporting has not changed but there is some evidence that people who had been victimised received more appropriate help. Devolution of services within a new mixed market of care requires that additional safeguards are put in place to protect vulnerable adults.

This paper reports the extent and nature of adult protection cases dealt with by two Social Services Departments during a twelve month period in 1995–6, within the framework of newly revised generic policies on abuse of vulnerable adults. The two counties varied in the level of reporting documented and in the number of cases logged for individuals who fall within the main four groups of ‘vulnerable adults’ covered by the policies. Arguments for consistent reporting are set out and the tension which exists between formal and informal approaches to the subsequent investigation of abuse discussed with reference to American vulnerable adult statutes. Adult protection work inevitably overlaps with existing planning and regulation systems such as social care assessment, care planning, the care programme approach and inspection and registration of residential homes. The point at which these systems need to be augmented by specific adult protection procedures is a matter of professional judgement and negotiation within and between agencies. Continued monitoring of cases reported under the procedures will allow these authorities to reflect on progress to date and may provide one set of norms against which other authorities can evaluate their own practice.