1. Safer Care North East Falls Task Group
Dr Fiona Shaw
Chair, Safer Care North East Falls Task Group
Consultant Physician and Geriatrician
NHS Newcastle and North Tyneside Community Health

2. Safer Care Falls Task Group
‘Do something’ to reduce falls and fractures
Across region
Doctors, nurses, falls co-ordinators, physiotherapists, OT’s, pharmacist, NEAS, osteoporosis specialists, third sector, commissioners
Link individuals and services to:
Share good practice
‘Collective voice’ to argue for change
Support change needed for wider implementation of good practice

3. The problem ……

4. Why is falls (and fracture) prevention important?
BIG cause of HARM
PCT / LA (pop 300,000, 45,000 age > 65) each year:
15,000 fallers age > 65, 2,200 A&E attendances
1,100 fractures including 360 hip fractures
25% of those admitted to hospital IP > 1 month
4x increased chance of admission to Care Home
Loss of confidence, social isolation
Recurrent falls – double mortality
Cost = £2.5 million per annum

5. Why is falls (and fracture) prevention important?
Falls and fractures are PREVENTABLE
Multi-factorial intervention reduces falls in community dwellers, hospital patients and care home residents by about 30%
Targeted exercise reduces falls in selected community dwellers by about 30%
Osteoporosis treatment would prevent 105 fractures, including 55 hip fractures per PCT / LA area in 5 years
Money saved = estimated £750,000 per year

6. What we did ……..
…. early now

7. Consensus recommendations for falls and fracture prevention
Organisational issues
Services delivered
In-patient / hospital falls
Care homes
Training
Information
Quality metrics
Services mapped themselves against recommendations …….

8. Service mapping …… Individual issues addressed:
Funding for Osteoporosis Specialist Nurse
Development of Falls Training
Recurrent themes identified across region:
Lack of robust pathways of referral from A&E to falls services
Assessment and treatment of osteoporosis

9. Falls (and fractures) CQUIN 2011/2012 written by Falls Group
Capture of falls information in A&E
Evidence of timely referral to falls service for patients who present to A&E with:
A fall
A blackout
A fracture relating to a fall
Evidence of timely and appropriate assessment by falls service including:
Initial falls assessment
Screening for osteoporosis
Falls Service

10. Information sharing website
Policies, protocols, assessment tools, training documents, patient information from group
Share with professionals – regionally and nationally
Live April / May 2011

11. Care Homes: sharing of good practice
Quality Standards: Sunderland
Similar process in progress in MRCPCT and Newcastle
Middlesbrough, Redcar and Cleveland
Primary Care Trust

12. In-patient audit tool
In-patient audit tool based on Reducing Harm from Falls
Being analysed …..

13. Regional outcome measures
Work with NEQOS to use routine data as regional outcome measures
Admissions with fractures
In hospital mortality for patients admitted with a fracture
Split into fragility fracture and fracture neck of femur
NHFD

14. Measurable outcomes Evidence of what we’ve done
Falls CQUIN, Website …..
Evidence of changes in practice
Care Homes, Training …….
Invitation to present our work at National Patient Safety Congress, May 2011
Falls and fracture prevention?
Too early to tell …. but we should do …

15. What went well
CQUIN on Falls in A&E and osteoporosis written by Falls Group in 2011/2012 North East CQUIN Scheme
Website
Establishing good working relationships amongst Falls Services in North East
Sharing and wider implementation of good practice
Commitment of group members to work together

16. Key lessons Importance of consensus approach
Benefits of working together and sharing ideas / good practice
Importance of identifying the right people to influence and help you get things done

17. Future plans Regional Falls and Fracture Prevention Strategy
Regional falls work – hosted by CDDFT
Implementation – group expanded to include relevant trust managers from across the region
Regional Falls and Fracture Prevention Strategy
Implementation of A&E CQUIN
Actions from in-patient falls audit
Completion of website
Further development of regional falls indicators
Active engagement with NEAS
Re-audit against Good Practice Recommendations

18. Falls and fractures are preventable ..
….. does your organisation provide appropriate services, training and have a culture of falls and injury prevention?
Contact