Coventry Physiotherapy Falls Service

Aims of the Coventry Physiotherapy Falls Service Provide a single point of access for patients, carers and health professionals Provide timely physiotherapy intervention to assess for and reduce the risk of falls Provide advice and education to patients, carers and health professionals

Falls Guidelines NICE Guidelines CG161 Falls: The Assessment and Prevention of Falls in Older People (June 2013) Patient Centred Care Case/risk identification Multifactorial falls risk assessment Multifactorial interventions Strength and balance training Education and Information giving Environmental Adaptations Professional education

Criteria to attend At risk of falling/ previous falls Over 65 years of age – 91% 70yrs + Fully weight bearing Able to understand/comply Balance/physical cause of falls Motivated to participate Cardiovascular stability Able to attend Newfield House

Access GP’s ~ 30% Refer for non medical intervention by Physiotherapy UHCW ~ 30% Dr Chaudhry – Falls Clinic (10%) Emergency Department/REACT Therapists on wards Integrated discharge teams CWPT ~ 30% Locality therapists/Fast Response/Community Matron/District Nurses Coventry Musculoskeletal Service/Podiatry Community Physio CMHT Other ~ 10%

Assessment Multi-factorial assessment Poly pharmacy Osteoporotic risk Cognition Functional ability Footwear Continence Vision Assessment of home hazards Hearing Physiotherapy assessment; Falls History – mechanical, medical, environmental, unexplained Past medical history and medication Balance – Validated Outcome Measures; TGUG, Berg Balance, Short FES-I, EMS. Muscle Strength, ROM, gait analysis, gait aids, pain, ADL’s. Person centred goals – Goal Attainment Scale – Quality Goal Referral to other services

Assessment Environmental assessment questionnaire; – Completed by patient/carer prior to attending for assessment – Onward referral onto Pathway locality Occ. Therapy OPAL – Environmental Adaptations Coventry Integrated Equipment services

Treatment Provided with individualised Otago exercise booklet –Expected to perform exercises 3-4 x week at home Patients attend weekly - –Newfield House for a 7 week programme Review week 7 –Group session - Individual exercise plans –Supervised by physiotherapist and assistant –Strengthening and balance exercises –Backward chaining –Education sessions provided –Discharge Planning

Review Patients receive telephone follow-up after 6 months of discharge from service Review short FES-I Planning Patients can contact during this period if having problems/further falls

Physical outcome measures July 2013 improved, on average by 20-30%

Outcomes Patient Satisfaction 100% strongly agree/agree that they were involved with goal planning 100% strongly agree that they would recommend the service to friends and family 0% in re-attendance at Accident and Emergency due to a mechanical fall 20 % return to reassessment 10 % attend classes again “The falls classes …gave me reassurance and confidence to go out alone and took away the vulnerability when going out alone..” “My treatment and care was excellent and most helpful as the lessons progressed I became much more confident and sure of myself and my ability to do the exercises.”

Contact Details Clare Mee – Community Physiotherapy and Community Neuro Rehab Team Lead – Claire Murphy – Physiotherapist Hannah Wade – Physiotherapist Donna Barnes – Assistant Practitioner