Background: Easy Read health information (ERHI) has the potential to promote engagement in health care for people with intellectual disabilities. This study examined how ERHI was actually employed by clinicians and received by patients. Method: Video recordings were made of 32 patients with intellectual disabilities attending a health check with primary care clinicians who had been given access to a range of ERHI, and 9 attending a health appointment with a specialist intellectual disability nurse. The recordings were analysed using conversation analysis. Results: Easy Read health information was visible in only 7 (22%) of the primary care health checks (though not always shared with the patients). Easy Read health information was used in sequences where clinicians offered unsolicited health advice and met with degrees of resistance from patients, though its potential for shared decision making was also evident. Conclusions: Easy Read health information can aid patient understanding and decision making, but attention should be paid to the interactional practices accompanying their use.