People with learning disabilities experience some of the most severe health inequalities in respiratory care. Chest infections and community-acquired pneumonia (CAP) remain a leading, often preventable cause of death, contributing to prolonged hospital stays, complex discharges and repeated readmissions. Life expectancy is significantly reduced, on average 19.5 years shorter than the general population and almost 40 years shorter for people from minority ethnic communities (LeDeR, 2023).
KMCH was developed in response to these challenges and evaluated in routine practice.
Alignment with NHS priorities
KMCH has been featured by NHS England as part of its regional spotlight on the North East and Yorkshire, highlighting local innovation that supports the newly published 10 Year Health Plan.
Hospital to community
A proactive, community-based approach that supports earlier action and reduces avoidable hospital admissions.
Analogue to digital
Digital tools that help teams identify risk earlier and provide clear, accessible information to support care.
Sickness to prevention
A whole-system focus on identifying modifiable risk and preventing respiratory illness.
What the service evaluation in Bradford showed
A retrospective service evaluation in Bradford compared unplanned respiratory-related healthcare use in the 12 months before and after implementing KMCH. The findings showed a significant reduction in unplanned respiratory related health care use across all services.
Unplanned respiratory-related healthcare use before and after KMCH implementation
| Metric | Total number Pre | Total number Post | % Decrease |
|---|---|---|---|
| GP contacts | 137 | 80 | 41.6% |
| OOH contacts | 31 | 14 | 54.8% |
| Paramedic visit (not conveyed to hospital) | 9 | 5 | 44.4% |
| A&E attendance | 38 | 16 | 67.9% |
| Hospital admissions | 29 | 7 | 75.9% |
| Virtual ward number of days | 13 | 0 | 100% |
| Days in hospital | 295 | 23 | 92.2% |
| HDU/ICU days | 120 | 33 | 72.5% |
| No of courses of antibiotics prescribed in primary care | 117 | 70 | 40.2% |
Key highlights included:
- 92% reduction in hospital bed days
- 76% fewer respiratory-related hospital admissions
- Over 40% reductions in A&E attendances, antibiotic prescribing and GP contacts
These improvements reflect earlier recognition of risk, more consistent decision making and better support for people with learning disabilities and their carers.
Economic impact
An economic analysis based on Bradford data and NHS tariffs estimated cost reductions of approximately 70% across primary, emergency and non-elective secondary care.
| 12 months pre pathway | 12 months post pathway | Savings / cost per patient | Total savings (based on 46 patients) | Proposed savings (based on 300 patients) | |
|---|---|---|---|---|---|
| Primary care GP | £6,287 | £3,673 | £57 | £2,614 | £17,047 |
| Emergency care Ambulance | £23,058 | £3,357 | £298 | £13,701 | £89,354 |
| Secondary care Non-elective admissions based on 46 patients (ICD10) | £169,537 | £46,433 | £2,676 | £123,104 | £802,852 |
| Totals | £198,882 | £59,492 | £3,031 | £139,419 | £909,254 |
National recognition
The evaluation has been shared through national platforms, including:
An abstract published in Thorax & feature by Respiratory Futures and the British Thoracic Society, Highlighting KMCH as an example of best practice in improving respiratory care for people with learning disabilities.