Transcript Slide 1

FALLS PREVENTION
HERTFORDSHIRE
Barry Fearon
Senior Commissioning Manager
Community Support
Health and Community Services
www.hertsdirect.org
CONTENT
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Falls Data
What is being done
– Promotion of Falls Prevention
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Care Homes
Falls Project
Herts Home Safety Service
Telecare
– Pilot work with North Herts Care Line
Falls Liaison Service
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FALLS DATA
15% to 33%
of falls are preventable
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=
£2.5 million
Savings at 15%
In Herts
PROMOTION OF FALLS PREVENTION
• Falls Campaign
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PROMOTION OF FALLS PREVENTION
• Falls Campaign
• Self assessment
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PROMOTION OF FALLS PREVENTION
• Falls Campaign
• Self assessment
• Day Centres
• Hertfordshire Community Equipment Service (HES)
• Talks to groups as requested
• Links to Public Health Forum of Fractures Falls and
Fragility
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CARE HOMES / HOME CARE
• Contract Management Monitoring
– Activities offered
– Safe use of medication
– Monitor falls
– Monitor complaints for reference to falls
– Report accidents to Care Quality Commission
• Range of training offered in partnership with HCPA
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FALLS PROJECT
Overview
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Joint funded project – Health & Community Services and
East of England Ambulance Service NHS Trust
First of its kind in the country
Service is accessed by 999 call
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Emergency Care
Practitioner
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Social Worker
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Social Worker assess older persons need and establishes
ongoing support required to help them remain
independent – equipment - telecare
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FALLS PROJECT
Aim of Project
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Report in 2009 – a fifth of all 999 calls to
the ambulance service was a result of
someone falling at home
Circa 70% were for older people
Prevent further falls
Reduce repeat 999 calls
Reduce the number of people admitted to
hospital following a fall
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FALLS PROJECT
Data – West Herts
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Operational between 8:00am and 4:00 pm
448 operational days
Successful preventions to hospital – 1,112 (82.74%)
Patients taken to hospital – 231
• 95 fractures
• 136 acute medical / serious injury
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HERTS HOME SAFETY SERVICE
• Service is for vulnerable people
• Home Security
• Fire Safety
• Falls Prevention
• Joint funded by Community Safety / Community
Support
• Service Provided by -
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HERTS HOME SAFETY SERVICE
Work Carried Out
• Home Security – advice, fitting window locks
• Fire Safety – checks / advice, fitting smoke alarms
• Falls Prevention
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Advice
Fitting grab rails
Replacing light bulbs
Clearing trailing wires
Marking edges of steps
Clearing pathways of potential hazards
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TELECARE
Telecare is a service that enables people, especially
older and vulnerable people, to live independently in
their own home. It is a way of enabling them to call for
assistance, at any time of the day or night. Depending
on the equipment installed, it may also be able to
summon help automatically when sensors in the home
are triggered by unusual behaviour patterns, or lack of
them.
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TELECARE
• May be a weekly charge for the lifeline
connecting to call centre (£2 - £4 per week)
• All sensors are provided free under FACS
• Carer linked telecare – no charge under FACS
• Telecare can be accessed privately
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PILOT WITH North Herts Care Line
(NHCL)
• NHCL – respond to lifeline/telecare alerts
• Calls data is recorded and falls
• Use data as early prevention
• Currently with Legal and Data Protection
• Links to Falls Liaison Service
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FALLS LIAISON SERVICE, NHS
HERTFORDSHIRE
• Introduced in October 2011.
• It was recognised that whilst there were some
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great services across the county there was a
lack of knowledge of what was available.
The idea of a Falls Liaison Service introduced a
vision of a single point of contact for both
healthcare professionals and patients to support
them in falls prevention and intervention.
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FOCUS
• Middle tier of non-hip fragility fracture patients
and individuals at high risk of 1st fragility fracture
or other injurious falls
• Creation of cohesive links between existing falls
prevention services in acute, secondary and
primary care setting to deliver Government
agenda for falls in the elderly.
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PRIMARY OBJECTIVES
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Primary objectives
– prevent further falls, and the injuries and loss of
independence that are often associated with them.
– identify people at risk of a first or subsequent
fragility fracture,
– assess individuals’ risks and establish appropriate
interventions to significantly reduce their risks.
To be achieved through integrated working links
between the East of England Ambulance Service, acute
trusts, primary and secondary health care teams and the
health and social care teams across Hertfordshire.
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KEY TARGETS
• To reduce fractured Neck of Femur by 10% by 31st March 2013.
• To reduce hospital admissions for falls by 10% by 31st March
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2013.
To reduce 999 calls for falls by 10% by 31st March 2013.
To contact all patients referred to Service within 7 days of
referral.
To operate a series of postural stability related programmes
with at least 60% uptake
To achieve gross savings on 2012/13 targets of circa £2.5m.
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CURRENT SERVICE PROVISION
1. Two exercise programmes provided in partnership working with
Herts Sports Partnership.
i. The OTAGO accredited Strength and Balance Programme –
in progress
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ii.
16 week programme, which runs 5 blocks per year, each block
overlapping by 8 weeks to reduce patient waiting time onto a
programme.
Programme accredited by OTAGO
Programme led by qualified OTAGO strength and balance
trained instructors.
Chair Based Exercise Classes to support and complement
Strength and Stability programme have recently been
introduced and will commence on 6th July 2012
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Both OTAGO and Chair Based Programmes are hour
long sessions followed by complimentary Tea, Coffee
and Biscuits and are facilitated by Hertfordshire Sports
Partnership.
Provision available to provide free or subsided transport
for patients that meet certain criteria.
– Lack of transport
– No family member or friend to transport to venue
– Living in outpost area
Both exercise classes are commissioned across
Hertfordshire in each of the 10 localities
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2.
Coordination of falls prevention intervention for
patients with more complex needs
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This comprises evaluating the patient in the home,
looking at what their health, social and wellbeing
needs may be and making the appropriate
referrals to those services tailored to patient’s
individual need.
If further clinical intervention is required it is
always discussed with the patients GP first.
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In addition to our core services we signpost both
healthcare professionals and patients to other services
in Hertfordshire depending on their need. This may
include Adult Care Services, Home Safety Services,
Telecare or physical activity classes such as Tai Chi
and Yoga amongst others things
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“our vision is to provide a robust, innovative and
comprehensive service with quality and patient care at
the very forefront.”
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PROGRESS SO FAR
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New referral form and pathway developed and
implemented. This has been disseminated electronically
to all GP’s and health teams in the locality. The referral
form is system one compatible and work is in progress
to code it for EMIS.
Meetings with GP practices to create awareness of
referral documentation and referral pathway
commenced; to continue through July/September 2012.
Work is in progress to develop a database for use and
to be shared by the PCT, Acute Trust and other health
professionals concerned with prevention of falls and falls
management.
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• 2 WTE Falls Coordinator posts in the E&N Herts
and WHHT Acute Trust hospitals funded by
PCT; one based at the Lister and the other at
Watford General. The post holder will work
closely with the Clinical lead and falls
coordinator of the falls liaison service and other
community teams to support the achievement of
the key targets of the service. Recruitment is
due to commence shortly.
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100% of all patients referred to the service receive their
first level contact assessment within the 7 day timeline.
Second level assessment is undertaken for patients with
complex issues who fail the first level assessment
process. Following this assessment they are referred to
the appropriate service for the required intervention after
discussion with their GP.
Approximately 90% of patients with complex issues
have received second level assessments to date. Work
is in progress to complete the remaining 10% by the end
of July 2012.
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4 falls prevention awareness building sessions have
been held in Watford for the Asian community.
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The activity booklet for the exercise programmes and
the falls brochure have been translated into 4 languages
namely; Guajarati, Hindi, Urdu and Punjabi for this
cohort of service users.
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The Falls brochure has been amended to make it more
culturally sensitive to the ethnic minority population in
Hertfordshire.
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WHERE DO WE GO FROM HERE?
• LAUNCH OF FALLS LIAISON SERVICE –
JULY 18th 2012, FEILDER CENTRE!
• CONSOLIDATION
• SERVICE DEVELOPMENT
• MORE JOINED UP WORKING
• AND YET MORE SERVICE DEVELOPMENT!
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