Northumberland ‘FISHNETS’ Partnerships for Older People Projects Denise Elliott

Origins of the Scheme Department of Health -March 05 Invitation to bid for ‘Partnerships Older People Project (POPP’) Funding 1-2 years from May 2006

Aims of ‘POPP’ To support older people’s wish to keep well, live as independently as possible and avoid hospital admissions/minimise hospital stays To find sustainable ways to shift resources from hospital and costly long term care to ‘prevention’ and keeping people well. To be ‘innovative’ & try out new ways of achieving the above National Test bed

Local Bid N’humberland -bid for approx. £1 million per year : 2006/7 & 2007/8 One of 19 successful bids out of 140+(eventually) Around the issue of Falls and their prevention

Why Falls ? 30% of over 65s and 50% of over 85s fall once a year Every 5 hours an older person dies as a result of a fall After a hip fracture 50% lose independence and 25% die 40% Care Home admissions are the result of a fall Falls in Care Homes are 3 times those of community dwellers

Effect of falls & fractures Personal –Loss of self confidence –Reduced activities and fear of falling –Decreased mobility –Isolation –Reduced quality of life –Disability –Increased dependency

Cost of Falls and Fractures 1989 £160 million 2000 £1.7 billion Total cost of falls in 1999 = 3x total NHS funding for mental health, coronary heart disease and primary care in England (Scuffham 2003) Ageing population

Cost examples in Northumberland Hip Fractures alone : 2003/ Cost over two years £9.1 million Ambulance Service: 2003/ ‘no admission’ calls Cost - £54,855

We have lots of fallers Hospital Episodes (FCE's), Fracture Femur (ICD10 S 72), , 65 years + N’hland

Risk factors for falling Poor lighting Steep stairs Loose carpets/rugs Lack of safety equipment Inaccessible lights/windows Problems with balance, walking, Sight problems 4 or more medications Impaired cognition Depression Postural hypotension Source DOH 2001 NSF Older People

However … evidence shows Number of falls and negative consequences - reduced if health and social care work together effectively to address falls and their impact. (DoH 2003 How can we help older people not to fall again?) Up to 30% can be avoided !

Will help older people keep FIT, INVOLVED, SAFE and HEALTHY, through investment in sustainable community NETWORKS. Northumberland ‘ FISHNETS’

Goes beyond the core business of health and social care to develop neighbourhood and community support networks with those who have regular contact with older people (e.g. housing staff, pension services, fire service, post, and retail as well as home care, NHS, community groups etc ). Northumberland ‘FISHNETS’

Targeted Education and training Evaluation OPPG/ Community involvement Raising awareness /communications Physical activity /lifestyle Home handy person /HIA Accreditation Intermediate care Technology /call centre Information /website Targeted interventionPrimary prevention So what exactly will it do?

Accreditation Home Care Agencies Housing Providers Care Home Providers Day Service Providers Community groups become recognised as organisations which deliver ‘good practice’ in the area of falls prevention Staff to assess and verify & run rolling programme

Training Falls awareness Medication ‘Low vision’ Foot care Dementia and person centred care Exercise leaders Specialist Training  Major investment – 6600 places  Training Coordinator with admin support

Training cont. Falls awareness : ‘Low Vision’, Nutrition, Foot care Issues, Environmental Issues, Practical Solutions, Appliances/Technology, Mental Wellbeing and Older People, Medicines Recording, ‘what, where, who’ Discussion and Action Who for?: Day and Home Care; Housing Support Staff, Care Home Staff, Users, Carers, Volunteers, Care Managers, Primary Care Staff Community.

 Aim: encourage, enable, sustain access to physical activity for older people  Coordinator  From: Walks / Gentle basic exercise / Tai Chi for low risk & general use To: Programmes for high risk group on gait, strength and balance Physical activity

Where?  In day services  Sheltered housing schemes  Community facilities, eg leisure centres  Intermediate care facilities  At home

Sustaining exercise programmes Achieved through social opportunities, supportive families/friends, home or day care arrangements Through linking people with community facilities and opportunities. ‘Buddy’ scheme

Small Task and Repair Service. Home safety Ability to fit equipment and repair Adaptations Improvements Energy efficiency and warm homes Home security Fund handy persons Home Improvement Agency to establish framework, & standards.

Information Technology and Equipment. Assistive technology, eg sensors & alarms, telemedicine; B.V.Call centre to coordinate activity, monitoring, and response Upgrade computer, and capacity and buy kit Other equipment (Joint Equipment Loans Store)

Project Management Project Plan Project Manager and Staff Project Group Leads Older People Project Board

Intermediate Care Identification of people at high risk of falls Multi factorial assessments and therapy for those identified at high risk Support to other aspects of project notably exercise Recruiting additional therapists

Evaluation team includes Newcastle University and Northumbria University FISHNETS Evaluation Benefits to Users What’s Replicable? Economic Evaluation

Communications Web site with information and links about services to keep you fit, healthy, safe and involved Schools Poster and Logo Competition Leaflets Publicity

To reduce the number of people who die or suffer painful and life changing accidents. To enable more older people to remain at home and active in the community To enable us to redirect funding from hospital services which ‘repair’, to community services which will reduce hospital admissions, promote independence, quality of life, and support more people to live at home The overall aim is: