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Setting up and running an Effective Falls Service

News and updates from today's conference in London focusing on setting up and running effective falls services and falls clinics through national updates, practical case studies and extended in depth sessions.

Chaired by Julie Windsor Patient Safety Lead, Older People & Falls NHS England through national updates, practical case studies and extended in depth sessions the conference looked at what excellence in falls services looks like, setting up and running an effective falls service, improving referrals, developing proactive preventative programmes such as exercise and balance training, delivering the individual multidisciplinary assessment, medication assessment, meeting the psychological needs of those who have fallen, developing links between community and acute falls services including in-reach and out reach, and how to measure and monitor the quality of your falls service.

Julie Windsor Patient Safety Lead, Older People & Falls NHS England presentation on ‘Setting up and running an Effective Falls Service’ opened the conferences with a focus on improving care and services for older people, and ensuring all clinicians acquire the knowledge and skills appropriate for safe and competent care of older people with comorbidities and frailty.

Julie Windsor Patient Safety Lead, Older People & Falls NHS England Full Presentation Click Here

In her presentation stated: 

“Falls Reminder – generally not accidental but results of complex interplay between - Functional decline (normal aging process + frailty), Medical decline, Social factors and The environment.”

“1/3 65+ will fall every year increasing to ½ 85’s”

“Hospital Falls - ¼ million falls reported annually to NRLS (600 + a day) and NHFD 1,859 hip fractures – not all reported to NRLS as severe harm”

“Hospital acquired Hip Fracture - Up to 20 % excess morbidity and mortality.”

“People with dementia are x2 as likely to fall than those without, x4 increased risk of hip # and x3 increase risk in 6/12 mortality”

“Falls and fractures are a major cause pf pain, disability and death in the UK”

“By 2025, the population of over 50 years will increase by 21% along with a 27% rise in total fractures. The combined social and health care costs of all fragility fractures alone in the UK us estimated to be £4.4billion”

“Where does falls fit in with the frailty agenda? – NICE’s Multimorbity: Clinical Assessment and Management guidelines are is in development and will be published in September 2016 – Falls will be included as a frailty trigger”

“Inpatients falls audit took place in 2015 – 136 Trusts, 5,000+ patients based around NICE and other best practice guidance”

“NICE Quality Standard 86 2015 – Care after an inpatient fall – goes across primary and secondary care and is a check list

  • Checks for injury before moving
  • When to call an ambulance (if care home / community hospital) Safe manual handling if fracture
  • Observations
  • Timescales for medical review
  • Post fall review of circumstances
  • Reporting requirements
  • Referral for specialist assessment (physio & home hazards)”

“It is important to know what doesn’t work – a really important study by 6 pack on falls prevention – it shows nursing interventions not as part as MDT interventions did not reduced falls or injuries”

Julie's biography:

Julie Windsor took up post in 2014 as the lead for older people and falls in the Patient Safety National Advice & Guidance Team in NHS England.

Qualifying as an RGN in 1988 with a career path entirely within older person’s services spanning primary, secondary and intermediate care she has been involved in developing and delivering falls services since 1996. She holds a master’s degree in gerontological practice.

Julie was a steering group member of the successful FallSafe and CareFall projects and a member of the NICE 161 (Falls) Clinical Guideline Development Group.  She is also a steering group member of the National Falls and Fracture Audit Programme (Inpatient Falls) and an executive member of the National Falls & Fracture Alliance Executive Board.

Keenly interested in falls research Julie is/has been clinical advisor to several falls studies; her particular interest is the built environment and patient safety technologies. 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.

Professor Cameron Swift Emeritus Professor and Consultant Physician King’s College London continued the morning presentations with a presentation on ‘What does excellence in falls services look like? Critical elements of an effective Falls Service’ discussing what do consultants want when they refer someone to falls service; the critical elements of an effective falls services; and how can falls services be improved? learning from the national audit.

Professor Cameron Swift Emeritus Professor and Consultant Physician King’s College London Full Presentation Click Here

In his presentation stated: 

“There are 4 key principles you need to know to deliver an effective falls service – understand the phenomenon, adhering to the evidence, coordinating across all boundaries and measuring outcomes”

“Commonly detectable signals for falls in later life, Ageing processes (diminished physiological reserve), Suboptimal physical fitness, Stable specific impairment (e.g. sensory, motor, visual, CNS) and Unstable systemic illness (diagnosed or undiagnosed)”

Also of interest:

Reducing Inpatient Falls & Harm from Inpatient Falls
Wednesday 18 May 2016
Colmore Gate Conference Centre, Birmingham

Falls Prevention and Management in Older People
Wednesday 6 July 2016
ICO Conference Centre, London

26 April 2016


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