{
  "abstract": "Introduction People with a learning disability experience disproportionately high rates of respiratory illness, premature death, more frequent and longer hospital admissions. The Keeping My Chest Healthy (KMCH) pathway was developed to address these inequalities by providing proactive, personalised respiratory risk management.It incorporates the identification and management of modifiable risks using a structured scoring tool, which was refined following the British Thoracic Society Clinical Statement (2023). The pathway also includes accessible care plans and co-produced multilingual resources.Objective To evaluate the impact of the KMCH pathway on emergency and unplanned respiratory-related healthcare usage among people with a learning disability.Method A retrospective service evaluation was conducted comparing respiratory-related healthcare usage in the 12 months before and after pathway completion. Of 122 individuals who completed KMCH between 2022 and 2024, 46 met inclusion criteria (≥12-month follow-up). The cohort included individuals with degenerative or progressive conditions and those receiving palliative care but excluded individuals documented as being at end of life. Data were extracted from clinical records.Results All outcome measures showed ≥40% reductions. Hospital bed days reduced by 92% (641 to 50), ICU/HDU days by 73% (40 to 11), and hospital admissions by 76% (29 to 7). A&E attendances, GP consultations, and antibiotic use each reduced by over 40%. None of the respiratory-related admissions were attributable to COVID-19.Estimated cost reductions, based on NHS tariffs for primary admission reasons, included £2,614 in primary care, £123,104 in non-elective hospital stays, and £13,701 in emergency care during the 12 months following KMCH completion.Abstract P130 Table 1Conclusions KMCH was associated with marked reductions in unplanned respiratory-related healthcare use among people with a learning disability, suggesting potential for wider adoption.As a retrospective evaluation without a control group, findings are descriptive and may have been influenced by factors such as seasonal variation, vaccination status, or wider respiratory illness patterns during the COVID-19 pandemic. Nonetheless, these findings support KMCH as a promising approach to reducing health inequalities and improving respiratory outcomes in this high-risk population. Further research, including prospective or controlled studies, is recommended to establish effectiveness, long- term cost benefits, and scalability.",
  "authors": [
    {
      "affiliations": [
        "Bradford District Care Foundation Trust, Bradford, UK"
      ],
      "name": "DL Smalley"
    },
    {
      "affiliations": [
        "Bradford District Care Foundation Trust, Bradford, UK"
      ],
      "name": "TJ Barningham"
    }
  ],
  "title": "P130 Improving respiratory outcomes in people with learning disabilities: evaluation of the ‘keeping my chest healthy‘ pathway",
  "uid": "dbfd2b01-19d2-5a77-a51e-1b44e0901fd5"
}