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This paper seeks to provide a commentary on the previous paper in this issue “Does he have sugar in his tea? Communication between people with learning disabilities, their carers and hospital staff”.

This commentary outlines some “reasonable adjustments” for people with learning disabilities in primary and secondary care.

The paper finds that there is a potential for Hospital Passport‐type documents to provide a better link between individuals and primary and secondary healthcare services.

The paper suggests that one way of helping to improve outcomes for people with learning disabilities would be to work more creatively across traditional boundaries.

Of all the different classes of substances that enter into our dietary the proteids are the most important, as they are not only absolutely essential for the support of animal life, but in the absence or deficiency of carbohydrates or of fat they can take the place of those substances.