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Purpose The purpose of this paper is to describe how, as part of a national initiative led by NHS England and key partners, it is transforming lives by helping people with a learning disability, autism or both to live more independent and better quality lives in their own home rather than spending many years in hospital unnecessarily.Design/methodology/approach The methodology applied was to capture the real experience of a person with a learning disability, autism or both who successfully moved from long-term hospital care to home. This was achieved through developing a narrative story by capturing their experiences in their own words and the words of the individual's support team who made this life changing event possible.Findings This story shows how with the right planning and support, people with a learning disability can live in their own homes, gain their independence and be supported to take risks.Originality/value This is an original case study that has not been published previously and has been written for the sole purpose of this journal. [ABSTRACT FROM AUTHOR]

Background Little attention has been paid on the carbon footprint of different healthcare service models. We examined this question for service models for patients with acute ST elevation myocardial infarction (STEMI). Methods We estimated carbon emissions associated with ambulance (patient) transport under a primary percutaneous coronary intervention (pPCI) care model based in tertiary centres, compared with historical emissions under a thrombolysis model based in general hospitals. We used geographical information on 41 449 hospitalizations, and published UK government fuel to carbon emissions conversion factors. Results The average ambulance journey required for transporting a STEMI patient to its closest care point was 13.0 km under the thrombolysis model and 42.2 km under the pPCI model, producing 3.46 and 11.2 kg of CO2 emissions, respectively. Thus, introducing pPCI will more than triple ambulance journey associated carbon emissions (by a factor of 3.24). This ratio was robust to sensitivity analysis varying assumptions on conversion factor values; and the number of patients treated. Conclusions Introducing pPCI to manage STEMI patients results in substantial carbon emissions increase. Environmental profiling of service modernization projects could motivate carbon control strategies, and care pathways design that will reduce patient transport need. Healthcare planners should consider the environmental legacy of quality improvement initiatives. [ABSTRACT FROM PUBLISHER]