NHS England National Falls Update
Julie Windsor Patient Safety Lead, Older People & Falls NHS England spole at today’s Falls Prevention conference on:
•NHS England Falls and Older People Programme update
•An update on the NRLS reported falls incidence for the 2013/14
•Falls and Fracture Alliance update
•Public Health Falls and Fracture Programme update,
•The CareFall junior dr’s e-learning module
Julie began her presentation with the Falls statistics that reflect the current situation and need for falls prevention. This includes NRLS data which shows an increase in harm but this could be due to an improvement in the quality of reporting which is the same in mental health hospitals.
Julie mentioned how Falls is now included for the first time in the NHS Outcomes Framework 2015/6 and Trusts will be measured on hip fractures from falls during hospital care. She added that initial review of recent National Inpatient Falls Audit data shows that some organisations are making improvement but overall there is still a lot of work to do.
Julie went on to outline education and training programmes including e-learning for nurses and doctors endorsed by NICE.
How to get falls e-learning fixed within your organisation in 8 ‘easy-ish’ steps
Falls elearning means that you are able to reach large numbers of staff for basic training freeing up valuable face - to - face time for more specialist falls teaching.
Preventing falls in hospital (nursing staff) and CareFall (medical staff) is available on many platforms: Electronic Staff Record (ESR) as a national course so will have the prefix ‘000’; it is also available on NHS e-learning repository, E-learning for Healthcare and Learning @ NHS Wales.
There are limited supplies of both courses on datasticks available from the Royal College of Physicians but anyone can do the courses via any of the platforms as long as they have an account. Some trusts have downloaded the courses on their own stand – alone e-learning systems.
Whatever platform you are using, the trouble with leaving it up to the learner to find it and put it in their own learning record is that busy clinicians struggle to do this however keen they are. Even if your organisation makes it a requirement to do the training it’s better to ‘fix’ the training into your Trust education strategy so it’s easy to access.
1. Most organisations will want to know how concordant staff are with training, and keeping an eye on numbers trained can help with knowing why some areas or staff groups perform better than others. This may be relevant for a falls lead for example, if a ward suddenly starts to have a lot of falls and subsequent investigation may reveal staff out of date or even have never done their falls prevention training. Knowing the numbers of staff trained can be very useful also for internal and external auditing.
The way forward is to get the training included as part of your organisational learning strategy; let’s say for example induction, essential skills updates or statuary and mandatory training.
2. Fixing the courses into your organisation requires a basic understanding of how training & development works in your hospital. Each Trust will have a training & development/ educational lead and you may even have an e-learning lead especially if a big Trust. The lead for education may not necessarily be responsible for medical and nursing staff so be sure to check and make sure you speak to all relevant people as they will be the key to making this happen.
3. Mandatory training schedules will be locally agreed by your Trust and will differ depending on the specialty, professional group and possibly the grade of staff. Such schedules are typically made up of a mixture of eLearning and face to face training. Find out or ‘map’ who does what and where then identify where your falls e-learning needs to go.
4. Once you have mapped out who does what it’s perfectly possible to have the falls courses linked to the electronic competency/ training matrix for any group of staff. For example, you may want all the registered nurses in elderly care to do the learning within 6 months of joining the organisation with a repeat at 3 years but it is not relevant for midwifery staff to do it at all.
5. You will need to think also how you get existing staff to do the course and if your organisation has a mandatory clinical skills update this may be the route in. You’re learning and development lead will be able to help you work this out as most likely it will need to be negotiated by specialty and by staff group.
6. You may think it relevant for all medical staff to have the course in their induction therefore it only needs to be done once. You may also wish to make sure that all FY1 and 2 junior doctors do the training in their induction, these are not permanent staff so may need to be treated differently in terms of induction training to other new joiners who are permanent staff. Then there’s the rest the existing medical staff to think about… talk to the medical education lead to get a plan together.
7. You may have other groups of clinical staff such as military personnel who access different learning systems who will also need to be thought about, so talking to their educational lead will be important too.
8. Either way, you need to talk to your learning and development leads to get a plan! It will take a bit of energy to get it all set up but it needs only to be done once. Then you can focus on ‘demand led’ bespoke falls training tailored to special staff groups or topics rather than allocating a lot of time to basic training.
FallSafe and CareFall can be accessed on the following e-learning platforms:
• -learning for Healthcare: http://www.e-lfh.org.uk/programmes/preventing-falls/
• the e-learning repository: http://www.elearningrepository.nhs.uk/content/carefall-reducing-inpatient-falls-risk-factors-and-post-fall-management
• the Electronic Staff Record- link to the catalogue entry it is: http://www.esrsupport.co.uk/nlms/catalogue.php?m=showCourse&ID=23166
• is also available for NHS staff on USB sticks if requested from the Royal College of Physicians
Julie’s full presentation is available for download at the end of this page.
Julie qualified as an RGN in 1988 with a career path entirely within older person’s services spanning primary, secondary and intermediate care and has been involved in developing falls services since 1996. Until recently Julie worked as a clinical nurse specialist for falls in a large acute trust. This placed her as the lead in the design, development and delivery of a trust wide inpatient falls strategy whilst ensuring quality improvements to the care of this patient group.
Her current appointment, which she took up in 2014, is to support the NHS England Patient Safety National Advice & Guidance Team by providing patient safety incident reporting intelligence via the NRLS & STEIS, clinical and professional information, knowledge, advice and guidance. Additionally, the role creates the opportunity to provide specialist support to internal and external stakeholders for improvements in relation to all aspects of the healthcare of older people and falls.
Julie is vigorously involved with falls research and is/has been clinical advisor to several falls studies collaborating with universities of Portsmouth, Bath and Newcastle, her particular interest is the built environment and patient safety technologies.
She was a steering group member of the successful FallSafe project and a member of the NICE 161 Clinical Guideline Development Group. She is also a steering group member the National Falls and Fracture Audit Programme (Falls Pathway) and an executive member of the National Falls & Fracture Alliance Executive Board.
Her current work programme includes:
• Collaborative work with the Royal College Physicians to develop an e-learning module for junior doctors.
• Collaborative work with the Royal College of Nursing, Birmingham, Berkshire and Ealing acute trusts to produce best practice guidance for ‘special observations’
• Collaborative work with CCG’s and acute providers to develop reporting definitions of serious and moderate falls to the NRLS and STEIS also definition guidance around avoidable v unavoidable falls.
Julie retains a clinical remit in acute care believing it important to keep connected to grass roots nursing and remembering that patients need to be at the heart of everything we do.
“I am an enthusiastic ambassador for the health service and for older people particularly those at risk of falling, a subject I am passionate about. As a proactive and experienced clinician and manager I’m thrilled to be working in NHS England and have the opportunity to influence and shape patient safety quality improvements at such high level. I like to be creative, innovative and gently challenge more traditional approaches. I am told I do with this good will, humour and a sensitive understanding of those I’m working with”.
Falls Prevention and Management in Older People
Thursday 9 July
ICO Conference Centre, London
Download: Julie Windsor full presentation21 May 2015