Respiratory care project for people with learning disabilities shows significant reduction in hospital admissions

A healthcare initiative that improves respiratory care for people with learning disabilities has achieved a 92% decrease in hospital bed days and a 76% decrease in respiratory-related hospital admissions.

The Keeping my Chest Healthy programme, led by Bradford District Care NHS Foundation Trust and co-developed with people with learning disabilities and professionals, is a respiratory pathway and online digital hub designed to help reduce hospital admissions due to chest infections among people with learning disabilities.

Research indicates that in the 12 months after implementation, there was a 40% decrease in A&E attendances, antibiotic prescribing, and GP contacts, along with a 54% decrease in chest infections. The researchers stated that the significant reductions in unplanned respiratory-related healthcare among people with a learning disability suggest potential for broader adoption.

Respiratory disease, especially pneumonia, is a major cause of premature death among people with learning disabilities, with the Learning from Lives and Deaths (LeDeR) report revealing that 24% of avoidable deaths were related to respiratory issues. It also raises the risk of hospital admissions, resulting in longer stays and repeat admissions.

Shifting respiratory care from reactive to proactive

The ‘Keeping My Chest Healthy’ initiative aims to address this by shifting care from reactive treatment to proactive prevention. Developed by a multi-disciplinary team of nurses, speech and language therapists, physiotherapists, dietitians, pharmacists, and oral health professionals, the pathway helps identify those at highest risk and supports them with personalised care plans and accessible information.

• Further reading: Improving respiratory outcomes in people with Learning Disabilities
• Further reading: COPD and learning disability: common conditions made complex

The project combines four related elements, including earlier risk recognition, more consistent decision-making, and better support for people with learning disabilities and their carers. These are:

• A system-wide way of working
  An evidence-based, multidisciplinary respiratory pathway that supports consistent practice across services.
• Personalised, accessible care planning
  Care plans that make sense to the person and those supporting them, focusing on everyday management and early recognition of change.
• A digital health hub
  A resource that supports awareness of respiratory health and highlights the modifiable risk factors that are often missed in routine care.
• Support for professionals
  CPD-accredited training and a full suite of practical clinical tools that link directly to the pathway and support confident, standardised care.

An economic analysis based on Bradford data and NHS tariffs estimated cost reductions of approximately 70% across primary, emergency and non-elective secondary care.

In November last year, the team won the Learning Disabilities Nursing Award at the Nursing Times Awards 2025, with judges describing the approach as “scalable, transferable and delivers both lifesaving outcomes and significant cost savings.”

Keeping My Chest Healthy can now be licensed by organisations across the UK.

Alison Bloomer

Alison Bloomer is Editor of Learning Disability Today.

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