What LeDeR is
LeDeR is the national programme that reviews the lives and deaths of people with a learning disability and autistic people in England. King's College London produces the annual report, and the programme is funded by NHS England. The 2024 report looks at adults who died between 2021 and 2024 and whose deaths had been reported to LeDeR by November 2025.
The headline numbers
- Age at death. The median age at death in 2024 for adults with a learning disability was 62.8 years, against 81.8 for the general adult population. Median age at death is not the same as life expectancy, and the report says so.
- Dying before 65. More than half (56.6%) of adults with a learning disability notified to LeDeR in 2024 died before 65. The comparable figure for the general adult population was 14.8%.
- Avoidable deaths. Among adults who had a LeDeR review, the share of deaths classed as avoidable fell from 46.3% in 2021 to 39.0% in 2024. The general adult population figure for 2024 was 21.1%.
- Treatable, not just preventable. Most of the gap comes from treatable causes: deaths that timely, effective healthcare could usually have avoided. In 2024, treatable causes accounted for 25.0% of deaths of adults with a learning disability, against 7.6% in the general population.
Which causes
Three causes made up nearly a third (32.8%) of avoidable deaths in 2024: pneumonia (unspecified), ischaemic heart disease and epilepsy. Deaths from respiratory diseases and from cancers both rose significantly between 2021 and 2024.
For adults with a severe or profound learning disability, the median age at death over 2021–2024 was lower again: 40.7 years for profound and 59.0 for severe learning disability. Adults with Down syndrome, recorded in 17.0% of the 11,687 reviewed deaths over the four years, had a median age at death of 59.8.
For autistic adults without a learning disability, the report urges caution because the numbers are small. Even so, suicide, misadventure or accidental death accounted for around a third (33.0%) of deaths reviewed over 2021–2024, the most common cause in that group.
What the reviews found about care
Reviewers recorded problems in care alongside good practice. In 2024:
- 40.5% of reviews identified problems with organisational systems;
- 39.8% found delays in care or treatment;
- 25.8% found that diagnosis and treatment guidelines were not met;
- 20.2% found gaps in care.
On the positive side, 79.3% of people had a care package that met their needs, 77.8% had reasonable adjustments provided, and 66.6% had the Mental Capacity Act correctly followed. Good practice was identified in 61.3% of reviews.
Read the other way, about a third of reviews did not record the Mental Capacity Act as correctly followed. The report notes that the remaining share includes both "no" and "not known" answers, so this is partly a recording gap.
What this means for your service
Most of what LeDeR highlights sits with the NHS, but support staff are often the first to notice that something is wrong. Practical steps:
- Chest health. Pneumonia is the leading avoidable cause. Make sure eating, drinking and swallowing plans are current, staff know the signs of aspiration and chest infection, and changes are escalated the same day.
- Epilepsy. Check every person with epilepsy has an up-to-date care plan, seizure records, rescue medication protocols where prescribed, and trained staff on every shift.
- Heart health and screening. Support people to attend annual health checks and cancer screening, with reasonable adjustments agreed in advance.
- Escalation. Delays were found in around four in ten reviews. Have a clear route for staff to raise concerns about a deteriorating person, and record what was done.
- Mental Capacity Act recording. Make capacity assessments and best-interests decisions easy to find. A good decision that isn't recorded may not show up in a review.
- Autistic people without a learning disability. Take low mood, anxiety and risk seriously, and make sure mental health support is adjusted to the person.
Sources
- King's College London, LeDeR programme page (LeDeR Report 2024, published July 2026): https://www.kcl.ac.uk/research/leder (checked 27 Oct 2026)
- King's College London, LeDeR 2024 key infographics (PDF): https://www.kcl.ac.uk/ioppn/leder/leder2024/leder-2024-key-inforgraphics.pdf (checked 27 Oct 2026)
- King's College London, LeDeR Report 2024 (main report, PDF): https://www.kcl.ac.uk/ioppn/leder/leder2024/leder-2024-report.pdf (link checked 27 Oct 2026; file too large for our fetcher, figures taken from the official infographics)
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