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People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This paper aims to detail the process of developing a risk stratification tool to identify those individuals who are higher risk of premature mortality.

This study used population health management principles to conceptualise a risk stratification tool for avoidable deaths in people with intellectual disability. A review of the literature examined the existing evidence of causes of death in people with intellectual disability. A qualitative methodology using focused groups of specialist clinicians was used to understand the factors that contributed towards avoidable deaths in people with intellectual disability. Delphi groups were used for consensus on the variables for inclusion in the risk stratification tool (Decision Support Tool for Physical Health).

A pilot of the Decision Support Tool for Physical Health within specialist intellectual disability service demonstrated effective utility and acceptability in clinical practice. The tool has also demonstrated good face and construct validity. A further study is currently being completed to examine concurrent and predictive validity of the tool.

To the best of the authors’ knowledge, this is the only study that has used a systematic approach to designing a risk stratification tool for identifying premature mortality in people with intellectual disability. The Decision Support Tool for Physical Health in clinical practice aims to guide clinical responses and prioritise those identified as at higher risk of avoidable deaths.

This preliminary study aims to examine the use of a co-designed immersive virtual reality intervention programme in improving access to health care for people with intellectual disability.

A co-production approach was used to design a virtual reality intervention in collaboration with people with intellectual disability, their families and carers. A mixed-method single sample pre-test-post-test design examined using a virtual reality intervention simulating health-care environments to improve access of attending health-care appointments. Qualitative feedback was used to understand participants’ experience and opinions of using the digital technology.

The study found that the intervention did help people access health-care appointment and reduced their fear. Improvements were also found in quality-of-life post intervention. Positive feedback was provided from participants on using digital technologies indicating the novelty of the approach and potential further applications.

To the best of the authors’ knowledge, this is the first study which has used virtual reality to support people with intellectual disability access health care.

This study aims to investigate the demographic and clinical characteristics associated with different risk stratification levels on the Decision Support Tool for Physical Health (DST-PH). The DST-PH was designed to stratify risk of avoidable mortality in adults with intellectual disabilities.

A prospective cohort study design was used. Data, including age, gender, ethnicity and completed DST-PH assessments, was collected from adults with intellectual disabilities within an NHS trust in the North-West of England. Descriptive statistics and a risk factor analysis were used to investigate differences between those rating Red, Amber and Green on the DST-PH.

Risk factor analysis revealed key clinical indicators linked to avoidable mortality. Notably, those experiencing posture or mobility difficulties, transitions in care, an untreated or unstable mental health condition or significant behavioural problems were identified to be at significantly heightened risk of avoidable death. These findings emphasise the importance of proactively recognising and addressing these experiences, particularly posture- and mobility-related challenges, in individuals with intellectual disabilities. It is important to note this study’s findings are based on a small sample size. Therefore, further research with a larger and more diverse population is recommended to validate and expand upon these results.

To the authors’ knowledge, this is the first study which has used a risk stratification tool to investigate the clinical and demographic characteristics of individuals with intellectual disability at higher risk of avoidable mortality.