News and updates from today's Falls Prevention Summit 2017
Conference chair Prof Cameron Swift (AM Chair) Emeritus Professor and Consultant Physician King’s College London & Specialist Committee Member, Falls Prevention Quality Standard NICE, opens the day with a presentation on 'The 2017 Quality Standard update for Falls in Older People' covering:
• the quality standard for falls assessment and secondary prevention in older people: where
are we now?
• the new Quality Standard for Falls Prevention: recommendations for inpatient falls
• implementation challenges and successes
• monitoring progress against the national standard
• meeting the Quality Statements in practice
Prof Swift's abstract: National Guidance on falls prevention (CG 21, CG161; QS 86) has been available since 20041,2,3. Additional evidence (previously absent) for the modest effectiveness of multifactorial interventions in inpatients underpinned the 2013 CG161 update. In spite of this, national audits continued to indicate unacceptable variation and deficiencies in the commissioning, organisation and delivery of care4,5. A further update of QS863 has been published in January, 2017. Provision of an effective falls service hinges on (1) A clear understanding of the significance of falls and falls risk as an age-associated syndrome; (2) Careful adherence to evidence in the interventions provided; (3) Crossing all necessary disciplinary and organisational boundaries in service configuration; and (4) Routine measurement and documentation of the results of the service. The evidence for the contemporary importance and cost-effectiveness of progressive, well-run services is robust and compelling. National guidance should be used to drive change and to avoid initiatives for which robust evidence is lacking.
1. National Institute for Health and Care Excellence, 2013 (June). Falls in older people: assessing risk and prevention. NICE Clinical Guideline 161. https://www.nice.org.uk/Guidance/CG161
2. Swift CG, Iliffe S, 2014 (Dec). Assessment and prevention of falls in older people – concise guidance. Clinical Medicine 2014 Vol 14, No 6: 658–62
3. National Institute for Health and Care Excellence, 2015 (March). Falls in older people. Quality Standard (QS) 86. https://www.nice.org.uk/guidance/qs86
4. Royal College of Physicians. Falling standards, broken promises. Report of the national audit of falls and bone health in older people. London: RCP, 2010.
5. National Institute for Health and Care Excellence, 2013.(March) https://www.nice.org.uk/guidance/qs86/uptake.
Prof Swift's biography:
Cameron Swift is a physician and clinical pharmacologist, Emeritus Professor of Health Care of the Elderly at King’s College School of Medicine, London, a former Chair of the Editorial Board of Age and Ageing and former President of the British Geriatrics Society. He served for 6 years on the Committee on Safety of Medicines and was a member of the UK Medicines Commission from 2001-5. As Physician to the DOH External Reference Group for the England National Service Framework for Older People, he chaired the Working Party for Standard 6 (Falls & Fractures). Subsequently he served on the NICE Clinical Guideline Development Group (GDG) for Falls Prevention (CG24/161; 2004/2013), and has been Chairman of the NICE GDG, & subsequent Quality Standard Topic Expert Group for Hip Fracture (CG124, QS86)(2011, 2012). He remains involved as an expert member in current updates of NICE guidance (2014) and Quality Standards (2016-17) on both of these topics.
Opening the afternoon session is Dr Amit Arora Consultant Physician and Geriatrician University Hospital of North Midlands, Stoke on Trent who delivers a presentation on 'Preventing deconditioning in hospitals to reduce falls -
Encouraging patients to sit up, get dressed and start moving' and discusses:
‘Sit up, Get Dressed, Keep Moving’: National Deconditioning Awareness and Prevention Campaign.
• The impact of deconditioning on falls
• Encouraging patients to Sit Up, Get Dressed, Keep Moving
• Our experience and the impact of falls
Dr Arora comments "Sometimes patients will not do what you want them to do, so it's up to us to encourage them"
Dr Arora's biography:
He has served as Chairman of the England Council of the British Geriatrics Society, Deputy Chairman of the Medical Specialties Committee of the British Medical Association and current President of the BMA Staffordshire division. He has been an advisor member for the Disability Living Allowance Advisory Board in England. He is an expert adviser to NICE and chairs the West Midlands Quality review Service for people living with dementia. He is also the clinical lead for NIHR CRN: Ageing for West Midlands.
He has a keen interest in National and International Health quality and policy for the ageing population and is a member of some national committees and working groups.
He is a full time clinician but has over 100 publications including invited book chapters, editorials and reviews. He is an examiner for the MRCP and DGM exams of the Royal College of Physicians of London.
Carrie Tyler Falls Practitioner Broomfield Hospital, Mid Essex Hospital Trust delivers an extended session on 'Broomfield Dignified Throne Toolkit: Preventing falls in hospital toilets and bathrooms and developing continence care plans that take into account the risk of falling' covering:
• analysis of falls in hospital bathrooms and toilets
• causes of falls in hospital toilets & bathrooms
• collaboration of existing work streams, falls, infection control and dignity
• achieving the 10 point dignity challenge
• innovation to achieve patient hygiene and dignity
Carrie Tyler began her nursing career in 1989 when she became a student nurse at the Whittington Hospital in North London. She enjoyed working there, and it was there that she discovered her passion for emergency medicine for older people, and became ward sister in 1999.
At Broomfield Hospital, Carrie has joined forces with the Dignity lead, Angela Wade and the Dignified Throne Audit was born. The audit uses a variety of simple techniques such as observational audit to establish if the toilets have the correct equipment, in the right place and in good functioning order. The audit is also very interested in the rationale behind staff and patient decision making as to whether to use the toilets and bathrooms or not. Carrie and Angela want to uphold the patient’s dignity, and promote the normality of using a bathroom and at the same time increase safety by reducing falls. The ethical dilemma also facing staff is when to leave a patient alone, is this promoting dignity? Or an act of neglect as the patient came to harm by falling in the bathroom? The Dignified Throne is hoping to answer this too.
7 July 2017