Falls and Fracture Prevention in Care Homes – The Results of 2 Year Project

1. Falls and Fracture Prevention in Care Homes – The Results of 2 Year Project Anita Walkinshaw & Ann Hunt Falls Prevention Co-ordinators Karen Brixey Osteoporosis Nurse Specialist 15 April 2010 Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

2. Overview • Results of project • Benefits of project • Group discussion about future Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

3. Population Trend Source: David Behan, Director General Social Care, Local Government and Care Partnerships • 2010 people over 65 will increase by • almost a third • 2022 20% of population will be over 65 • 2027 increase by 60% in number of 85 year olds (DoH) Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

4. Population Trend - Suffolk Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

5. Recap: Care Home Project background • 2 year project Oct 2007 – Oct 2009 • 400 homes sent letters • Offering • Falls and bone health training for all staff including where to refer for those at risk • Indentify Falls champions • Further training • Monthly reports • Introducing assistive technology • Signposting to other services • Identifying exercise/activities in each home Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

6. Focus of Project • High ambulance callers • cost £245/call • High A&E users • High unplanned admissions • Fracture neck of femur - £12 -£16 000 Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

7. Recap: Participating Homes • 89 homes actively involved • 72 – Falls Champions trained • 44 - homes have falls champions • 748 – Staff trained • 515 – residents trained • 39 - homes send in monthly reports Note: Data only for East & West Suffolk Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

8. Participating homes Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

9. Control Group • Initially to compare and contrast --------------------------------------------------------------- Results showed decrease in falls – Reasons. • Homes previously involved. e.g. work done by osteoporosis nurse specialist • Water for health • Nutrition • Assistive technology • General falls prevention work – e.g. National Falls Awareness Week • Signposting Hence: Results used in the analysis Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

10. Control Group Homes Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

11. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

12. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

13. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

14. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

15. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

16. Number of falls into A&E with Fractures from participating and control group Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

17. Cost of admission for fractures Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

18. Spending on Admissions for fractures • 2007/8 - c£2.45million • 2008/9 – c£2.42 million • 2009/10 – c£528k • Financial impact is wider when you consider other injuries, social care cost, medication costs, equipment costs, etc. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

19. Cost of project • £5K approx spent on letters & leaflets • 2 – 2.5 days per week by 3 staff and on-costs • Training material Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

20. Ambulance Call outs Period: 2007-2010 • 73% reduction in participating homes • 85.7% reduction in control group • 78.5% reduction overall Project Period: • 31.7% reduction participating homes • 32.8% reduction in control group • 32.1% reduction overall Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

21. Cost of Ambulance call out Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

22. Ambulance Data on costs • 2007/8 - c£83k • 2008/9 – c£75k • 2009/10 – c£51k Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

23. Benefits of the Project • Increased awareness around care pathway and referral processes • Increased referrals to GPs, Local Healthcare teams, ACS, etc • Decrease in ambulance call outs • Decrease in emergency admission • Early intervention Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

24. Benefits of the Project - cont • Solid infrastructure with falls champions driving it • More residents on bone protection medication • Increased awareness around assistive technology • Increased partnership working Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

25. Benefits to Residents • Independent living • Improved quality of life • Empowering • Economic contribution Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

26. Projected Savings • If 266 homes were to participate in a same/similar project, based on current analysis, in a single year; a potential £7.13 million could be saved. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

27. Risks if nothing is done • Population trend is up • Falls and fractures are likely to increase • Increased cost & resource pressure • Disillusioned falls champions/care homes Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

28. Population Trend - Suffolk Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

29. Proportion of population (65 - 74yrs) requiring hospital services at least once per year - Suffolk Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

30. Proportion of population (75 - 84yrs) requiring hospital services at least once per year - Suffolk Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

31. Proportion of population (85+yrs) requiring hospital services at least once per year - Suffolk Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

32. In Summary • Falls, osteoporosis and fractures are major public health problems • Population trend shows increase in number of older people • High risk people need to be identified and treated • Health education of staff, services users and carers is crucial • Project shows positive results so invest to save is critical • Partnership working is absolutely essential to help people to remain independent and have quality of life Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

33. Other General Falls & Bone Health Interventions in Suffolk • Perhaps invite us back to future meetings to give an overview Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

34. Questions for Discussion • Where do we go from here? • Future of project • Other homes not involved • Should funds be ring fenced for falls prevention work? If so, how much, who, what? • What can partner organisations offer to prevent falls and fractures, and how do we streamline resources and share good practice? Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

35. Thank you for listeningAny Questions/ Comments Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.