Across Southwark and Lambeth, falls account for a significant number of fractures, injuries and hospital admissions, amongst people aged 65 and over.
It is forecast 5,173 falls and 296 hip fractures will occur amongst Citizens aged 65 and over in 2015/16 in both boroughs. This could cost NHS Southwark CCG and NHS Lambeth CCG £6,448,403 to support these people with their recovery. However, the same evidence forecasts £1,303,733 of this cost could be prevented through appropriately designed treatment programmes. These treatment programmes, including falls prevention exercise, aim to reduce the number of falls that occur.
The figures above only include citizens who have visited Accident and Emergency, it does not include people who may fall but do not need to attend hospital. Therefore, the total health and social care costs are predicted to be much higher.
The real impact of falling to a person, regardless of whether they sustain a major injury or have to be hospitalised, is much wider and more significant than just any physical harm. It can include loss of confidence, social isolation, physical deterioration, inactivity, anxiety, depression and a greater dependence on family, friends and social and community services. This has a major impact on an individual’s quality of life.
A number of years ago, the Southwark & Lambeth Integrated Pathway for Older People with Falls (SLIPs) was set up to appropriately care for local people that have fallen. Research has proved that exercise is the best single intervention to prevent falls. The SLIPs service provides falls clinics and multi-disciplinary assessment for citizens who have fallen, and ensures their needs are identified and treated. Treatment options include strength and balance exercises to reduce the risk of further falls.
Research has also confirmed that new strategies for prevention are needed, targeting the general community as well as those at high-risk of falls. As a result, the project team within the Community Rehabilitation and Falls Service (CRFS) has been working to design, test and implement a new care pathway for community falls exercise since October 2013.
The aim is to proactively identify a high number of citizens at lower risk of falling and fast-track them into community exercise classes.
Research evidence tells us that if people at risk of falling are identified earlier and provided with evidence-based treatment, this will reduce their risk of being injured in a fall. It is anticipated up to 43% of falls and 61% of falls resulting in fractures in people aged 65 and older could be prevented with appropriately designed treatment programmes.
The Strength and Balance Helpline was launched to improve access to the service. Citizens, their family and friends and health and social care professionals can use it to discuss their concerns about falls, or refer someone they know who has had a falls or has concerns about falling.
Previously physiotherapists determined what falls treatment is most appropriate for each person. Therapy assistants have been trained to triage citizens over the phone and identify their falls needs; they can then refer them into the most appropriate service. It is being investigated whether this is more cost effective, whilst remaining safe, than more traditional methods using qualified staff.
Due to the high level of need more community exercise classes are being launched in Southwark and Lambeth to increase capacity, so more people can benefit from the classes. These additional classes are being set up in areas where high demand has been identified and use community based venues.
Research evidence tells us that falls prevention exercise only works if it is completed regularly for at least 50 hours. Therefore, it is being explored how to most effectively encourage people to start doing the exercise they need, commit to the exercise classes and exercise at home to maximise the benefits.
A variety of data is being collected and analysed to support this project to demonstrate the benefits it is having locally.
Voluntary and Community Sector and Citizen involvement
In order to achieve all of the aims above the project team has undertaken public engagement and partnership working with citizens, the voluntary and community sector and primary care. To help improve the community exercise classes they have also organised focus groups with current class attendees.
If you are interested in finding out more about the Falls Project, please contact the Strength and Balance Helpline for more information – 020 3049 5424.