Overview Falls and fractures in people aged 65 and over account for - - PowerPoint PPT Presentation

Overview

• Falls and fractures in people aged 65 and over account for over 4 million hospital bed

days each year in England alone

• The healthcare cost associated with fragility fractures is estimated at £2 billion a year
• Injurious falls, including 70,000 hip fractures annually, are the leading cause of accident-

related mortality in older people

• After a fall, an older person has a 50 per cent probability of having their mobility

seriously impaired and a 10 per cent probability of dying within a year

• Falls destroy confidence, increase isolation and reduce independence, with around 1 in

10 older people who fall becoming afraid to leave their homes in case they fall again

Hounslow Context

• Total annual spend on falls in Hounslow is estimated at £3,830,033 (£3,792,201 on treatment, and

£37,833 on prevention).

• The current expected annual number of falls in the 65+ years is around 2,670, which is expected

to rise to 8,852 by 2020.

• The report identified key recommendations as a means of reducing falls and related injuries in

Hounslow’s elderly population, such as:-

• More should be spent on prevention as there are clear returns on investment
• Preventative physiotherapy can have an impact on reducing the number of falls in Hounslow

by 576 per year, resulting in an annual cost saving of over £800,000.

• In-depth analysis of the falls prevention pathway is essential for understanding the most

effective interventions within the pathway that can prevent multiple hospital admissions due to recurrent fall currently 38% of those who suffered a fall had two or more falls related hospital episodes).

Source: Falls deep dive (Public Health 2016)

Falls prevention co-ordinator:

• A new role of falls co-ordinator was created and appointed to in May 2016 reflecting the need to

address the issue of the high number of falls in Hounslow. The role is funded by IBCF.

• Remit:
• The Falls Prevention co-ordinator provides specialised assessment and treatment for people

in the community who have had falls, have a fear of falling or poor balance/mobility or who are considered to be at risk of falls.

• The falls prevention co-ordinator provides an accessible service that helps to reduce the risk
• f falls, trips and slips within the home and in the community. Although not all falls can be

prevented, advice and information can be provided to minimise the risk.

• The Falls Prevention Co-ordinator works closely with ICRS, CRS, housing, social care, CIDS

team, hospital discharge team, SIS, community opticians, occupational therapists, physiotherapist, The Mulberry Centre, GPs and voluntary sector organisations.

• Identify collaboratively develop pathways of referrals and access to services.
• Addition new role of LAS falls prevention officer created specifically to work with the London

Ambulance Service to reduce repeat hospital admissions.

Key work streams:

• Assessment- Develop and provide effective, targeted falls assessments in line with

NICE guidance. Aim to deliver 470 in a 12 month period. Effectiveness measured by evidenced reduction in A&E attendances/admissions through QIPP tracking.

• Training- Develop tailored training programs for staff of residential in borough care

homes and PCF domiciliary care workers.

• OTAGO- Implement pilot OTAGO program; working with colleagues from ICRS/CRS,

identification & recruitment of older people aged 65+. Monitor and track results. Pilot results will inform and shape the role out to wider audience.

Assessment so far….

• 270 falls assessments completed between June 16- August 17
• Most common issues arising from falls assessments:
• Medication reviews not taking place
• Balance problems not identified by GP or other are professionals
• Eye/ hearing issues - professionals are not asking if they can see or hear
• Hydration- very few older people understand the importance of hydration
• Most common referrals from assessments:
• Community recovery service (CRS/ICRS)- physiotherapist, equipment assessment
• Handy persons grab rails- appointments to measure and fix rails
• Home eye tests

Training

Delivered

• Stay Well event 2017 x 2
• Chiswick War Memorial
• Cloisters care home
• Sandbanks care home
• Jessop Sheltered Housing Coffee morning
• Carers event Sainsbury
• Social Care team meetings
• CRS team meetings
• Melody Court- housing association

Planned

• Deliver tailored training programs for staff in:
• Residential and nursing in borough care

homes

• PCF domiciliary agency care workers
• Sheltered housing scheme managers

OTAGO- strength & balance program

Implementation of the OTAGO program; working with colleagues from ICRS/CRS, identification & recruitment of older people aged 65+ to participate in the strength and balance program. Pilot:

• 10 week program hosted at a local venue
• Providing strength & balance exercises
• Provide opportunity for external services to attend and provide education of services that

exist to complement program

• Assess and review progress of attendees during and integrate in to existing activities on

completion

• Pilot finding/results will inform recommendations re the role out to wider audience.