This article aims to highlight the delivery of health care to people with learning disabilities (PWLD) in the context of new Department of Health guidance and implementation of the Mental Capacity Act (2005). We seek to identify a myriad of barriers to health care delivery in this population and look at strategies to tackle these barriers. We will also consider the issue of capacity, which is particularly important for PWLD. We will highlight the importance of recognizing this population's enhanced baseline medical morbidity and how a best interests team approach is optimal when targeting interventions.