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Thank you for visiting our ‘Falls prevention’ page.  The information you will find here is designed to support staff in undertaking their duties by providing information in relation to risk assessments, risk factors and ways to prevent falls and effectively support people who have fallen in our care.

Falling can happen to anyone, but for older people the risk is particularly high and the consequences can be severe, including distress, pain, injury, loss of confidence, loss of independence and mortality.

Falls are a common and serious health issue for older people, with around a third of all people aged 65 and over falling each year, increasing to half of those aged 80 and over (NICE 2013).

Most falls do not result in serious injury. However, there's always a risk that a fall could lead to broken bones and can cause the person to lose confidence, become withdrawn and feel as if they have lost their independence. Hospitalisation can often cause changes in a patient's ability to walk or get out of a bed or a chair and then this puts them at higher risk of a fall.

An estimation of the impacts of coronavirus (COVID-19) on physical activity and falls in older adults and recommendations to mitigate these effects.COVID-19: wider impacts on people aged 65 and over - GOV.UK (www.gov.uk)

Public Health Englands COVID-19 Cabinet commissioned the Health Economics and Modelling Team (HEMT) to undertake work to identify the wider public health impacts of COVID-19 and carry out modelling in priority areas to quantify these impacts.  This study looks at how the wider impacts of COVID-19 have affected older people (over 65 year olds), with a focus on deconditioning and falls.

Key findings were:

  • 32% of older people were inactive (did either no activity or less than 30 minutes of moderate activity per week) between March to May 2020. This has increased from 27% in the corresponding period in 2019

  • average duration of strength and balance activity decreased from 126 to 77 minutes per week in March to May 2020 compared to the corresponding period in 2019

  • inequalities in physical activity have persisted, older people in the most deprived group (defined by Index of Multiple Deprivation) were more likely to be inactive than those in the least deprived group in both 2019 and 2020

  • older people experienced a considerable reduction in strength and balance activity between March to May 2020, with the greatest change in the 70 to 74 age group with a 45% (males) and 49% (females) decrease observed in activity

  • without mitigation, modelling predicts that: • 110,000 more older people (an increase of 3.9%) are projected to have at least one fall per year as a result of reduced strength and balance activity during the pandemic

  • the total number of falls could increase by 124,000 for males (an increase of 6.3%) and 130,000 for females (an increase of 4.4%)

  • for each year that the lower levels of strength and balance activity observed during the pandemic persist, there is projected to be an additional cost to the health and social care system as a result of the change in predicted related falls of £211 million (incurred over a 2 and half year period)

Key recommendations for the whole population are:

  • promotion and increased availability of strength and balance activity for older adults, involving a gradual increase in activity in order to reduce falls risk and to enable safe and confident participation on other forms of exercise and physical activity

  • ensuring that physical activity recovery measures reach those who stand to benefit most from them, including older adults who shielded, with multimorbidity, with dementia, in social care settings and from more deprived backgrounds

  • identifying locally which older adults have reduced their levels of physical activity during the COVID-19 pandemic, with a focus on populations where the largest reductions are likely to be found. The largest reductions in strength and balance activity identified in this report were seen in males aged 65 to 74 and females aged 65 to 84

Key recommendations for the targeted population are:

  • referral of older adults with functional loss, transition towards frailty or fear of falls resulting from deconditioning to appropriate rehabilitations services

  • raising awareness amongst health and social care staff of post-COVID-19 syndrome, communicating the risks of building up levels of activity levels too rapidly and the need to refer to post-COVID-19 syndrome clinics where symptoms are severe, in order that clinical judgement can be used about whether graded exercise therapy should be recommended

In March 2020 ‘Zero Falls in Our Care’ was identified as a Big Hairy Audacious Goal (BHAG) for the whole organisation with the following objectives agreed as part of the operational plan, which have continued into 2021/22:

  • 100% of in-patients have a falls screening within 24hrs of admission and those at risk of falls have a multi-factorial risk assessment and management plan in place by March 2022.

  • 20% reduction in harm related to falls in inpatient areas taking account of the previous 24 month rolling baseline by March 2022.

  • Standardised falls risk assessment process across community settings by March 2022.

  • Develop a clear pathway for access to support services for those identified as at risk of falling in the community by March 2022, supported by our integrated care teams.

To progress these objectives design thinking engagement sessions were completed with a range of colleagues across the Trust asking a series of questions in an interview style approach to gain feedback. Key Falls themes from the engagement sessions were identified which have informed the co-production of the driver diagram below:

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A revised project implementation plan has been created using the drivers above and is aligned to the BHAG objectives. Progress is monitored via the Zero Falls in Our Care Group who meet on a monthly basis.

If you would like to more about this work please contact the Trust Wide Falls lead Lynn King.

As part of the work to achieve ‘Zero Falls in Our Care’,  Level 1: Falls Prevention training has been co-designed with the subject matter experts (SMEs) from our Divisions and through the Trust Wide Zero Falls In Our Care Group including lived experience.  It has been designed for all clinically facing staff and will take no more than 20-30 minutes to complete via e-Learning.  

This training aims to help staff learn about falls, how they can have serious consequences and what can be done to reduce falls. 

Falls can happen to anyone and they can have significant consequences regardless of age.  All staff can have a part to play in managing and reducing the risk of falls by undertaking this training, being aware of falls risks and assessing, managing and referring people to appropriate services where required.

Level 2: Falls Training has been developed to support those areas where the Multi Factorial Risk Assessment Tool process is being rolled out.  Where this is the case this training will be offered to staff champions to support the successful roll out.

Level 3: Falls Training is a more advanced training course for those clinicians who work in an area where falls prevention and management is key.  This course is just in the process of being co-developed and more information will follow once the training is available to book via the L&D Prospectus.

For more information on falls prevention and management please contact your Falls Leads:

  • Francesca Cairns – Deputy Director of Therapies, Psychological and Allied Health Professionals

  • Lynn King - Trust Wide Strategic Recovery and Allied Health Professions Lead
  • Helen Lockley and Krystina Crolla Barker – Local Division

  • Dale Williams and Nicola McNulty – Secure and Specialist LD Division

  • Jason O’Flaherty and James Hester – Mid Mersey Division

  • Anne Bennett, Anne Marie Howard and Jean Clare – Community Division