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News and updates from today's Falls Prevention conference

Conference chair Julie Windsor Patient Safety Clinical Lead - Medical Specialties/Older People NHS Improvement, opens the day with a focus on 'NHS Improvement national falls update' discussing:

• Patient Safety Team falls prevention activities and the National Falls Collaborative
• National Falls Coordination Group- guidance for commissioners 
• Falls and Fragility Fracture Audit Programme- preparing for the next audit round

Julie comments:

"NHS treats 1 million patients every 36 hours

Reporting errors mean that others can learn from these

Not all investigations need to be SI’s

Stop asking “what can I do to stop people falling?” and start asking “what can I do to stop THIS individual falling?”

Nursing intervention NOT as part of a MDT does not reduce falls or injuries

PreFIT – ground breaking study:"

Presentation Abstract

Short overview of the National Reporting and Learning System 
Examples of learning and action from reported falls patient safety incidents
Round up of some national falls activities and publications.
National falls consensus statement : support for commissioners
National inpatient falls audit – preparing for the next round

Biography: Julie Windsor MSc RGN  |NMC 84L0427E|

I took up post with the Patient Safety National Advice & Guidance Team in 2014.
Prior to that and qualifying as an RGN in 1988 with a career path entirely within older person’s services I held senior operational nursing roles in both acute hospital and community care. I have a master’s degree in gerontological practice. 

Always concerned about things that mattered to older people I first became aware of falls whilst the clinical manager of a day hospital in 1996 thereafter I co- led the setting up of the regions first multi-professional falls clinic. As ever one thing led to another and after a few years working as a district falls coordinator setting up falls services across health and social care boundaries I returned in 2008 to my first love, acute hospital care and set about improving falls prevention in a large 2,000 bed district general hospital.

I was fortunate to be a co-designer of the successful FallSafe and CareFall projects and a member of the NICE 161 (Falls) Clinical Guideline Development Group.  I am currently a steering group member of the National Falls and Fracture Audit Programme (Inpatient Falls) and a member of the National Falls Prevention Coordination Group.

Prof Cameron Swift Emeritus Professor and Consultant Physician King’s College London & Specialist Committee Member Falls Prevention Quality Standard NICE, follows with a session on 'The Quality Standard for Falls in older people: Assessment after a fall and preventing further falls' and discusses:

• the quality standard for falls assessment and secondary prevention in older people: where are we now?
• implementation challenges and successes
• monitoring progress against the national standard
• meeting the six Quality Statements in practice

Prof Cameron Swift comments:

"Lots of standards referred to and lots of charts and graphs shown – all of which were in his presentation that were included in the packs.  Notes I did take are:

Always be “falls” aware when you have contact with a patient

Falls preventions is  an indicator of good care.  Getting that right means we are getting a lot right for older people.

Falls preventions is a complex issue

The costs to the NHS is £2.3 billion a year, plus there is a huge suffering cost to the individual."

Presentation Abstract

National Guidance on falls prevention has been in place since 20041,2,3, in spite of which national audits continue 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.  The challenges and opportunities for leadership are clear.
1. National Institute for Health and Care Excellence, 2013 (June). Falls in older people: assessing risk and prevention. NICE Clinical Guideline 161.
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.
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)

Prof Cameron 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 sessions is Dr Parul Shah (Associate fellow of The Higher Education Academy) Consultant Physician General and Elderly Medicine with special interest in Falls and Syncope Clinical lead for Frail Elderly Northampton General Hospital NHS Trust, who will present 'Multidisciplinary assessment and delivering individual post fall protocols to care for any older person who has fallen during their stay' and discuss:

• identifying the root cause and contributing factors to a fall
• a step by step guide to effective individual multidisciplinary assessment
• reducing future falls risk: education and training of frontline staff
• implementing an individual post fall protocol in practice

Presentation Abstract:

•    Provide understanding of multifactorial aetiology behind falls in older people 
•    Give tips on identifying syncope syndromes and separating them from falls
•    Share my knowledge and experience of autonomic issues in older people (including Tilt table testing) and strategies to deal with postural hypotension and immobility in older people
•    Raise awareness of effects of polypharmacy on older people 
•    Highlight the importance of Education and training aspect of falls prevention 
•    How to implement ‘Step by step’ approach to falls assessment using Multidisciplinary team work

Dr Parul Shah's biography:

I have been practising as Consultant at Northampton General Hospital since 2004. I have established myself as a Consultant Physician in integrated medicine with special interest in falls and syncope in older people.  I also lead and manage Tilt table service for the trust.  I currently co-chair Falls Prevention Steering Group for inpatient falls prevention and lead the service for Elderly medicine at NGH.  As a lead clinician for falls, I oversee development of orthogeriatric services as well as community falls services.  As part of quality improvement activity I review all serious incidents which are related to falls at our trust and produce a report for risk management as well as for clinical governance board and ensure a robust action plan. 

Also of interest:

Falls Prevention and Management in Older People
Wednesday 10 May 2017 
The Studio Conference Centre, Birmingham

Falls Prevention Summit 2017: Reducing Inpatient Falls & Harm from Inpatient Falls
Friday 7 July 
De Vere West One Conference Centre, London

27 March 2017


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