This paper is a short report of a pilot falls prevention programme that took place in an NHS Trust in Wales in 2005-06. The paper includes the epidemiology of falls, the health and social policy framework in Wales, the questions, governance and funding, the setting, patients and methods, a discussion of the findings, and a final summary.
This paper is a short report of a pilot falls prevention programme that took place in an NHS Trust in Wales in 2005-06. The paper includes the epidemiology of falls, the health and social policy framework in Wales, the questions, governance and funding, the setting, patients and methods, a discussion of the findings, and a final summary.
One in three people aged over 65, and half of those aged over 80, fall at least once a year. Falls cost the NHS more than £2 billion per year. With the number of people aged 65 and over predicted to increase by 2 million by 2021, the costs incurred of treating patients across health, community and social care services are set to rise further. This paper uses Torbay’s unique patient-level linked data set to explore the NHS and social care costs of the care pathway for older people in the 12 months before and after being admitted to hospital as a result of a fall. On average, these costs for each patient who fell were almost four times as much in the 12 months after admission for a fall as the costs of the admission itself. Over the 12 months that followed admission for falls, costs were 70% higher than in the 12 months before the fall. Comparing the 12 months before and after a fall, the most dramatic increase was in community care costs (160%), compared to a 37% increase in social care costs and a 35% increase in acute hospital care costs. While falls patients in this study accounted for slightly more than 1% of Torbay’s over-65 population, in the 12 months that followed a fall, spending on their care accounted for 4% of the whole annual inpatient acute hospital spending, and 4% of the whole local adult social care budget. The authors discuss how linked health and social care data can be used to inform policy and practice. The findings strengthen the case for an integrated response for frail older people at risk of falls. However, to allow comparison of different models of care, other localities need to emulate Torbay’s recording and analysis of whole-system data at the patient level - which, to the authors' knowledge, is the first time that such detailed analysis of the costs in the health and social care system has been carried out in relation to falls patients in England.
(Edited publisher abstract)
One in three people aged over 65, and half of those aged over 80, fall at least once a year. Falls cost the NHS more than £2 billion per year. With the number of people aged 65 and over predicted to increase by 2 million by 2021, the costs incurred of treating patients across health, community and social care services are set to rise further. This paper uses Torbay’s unique patient-level linked data set to explore the NHS and social care costs of the care pathway for older people in the 12 months before and after being admitted to hospital as a result of a fall. On average, these costs for each patient who fell were almost four times as much in the 12 months after admission for a fall as the costs of the admission itself. Over the 12 months that followed admission for falls, costs were 70% higher than in the 12 months before the fall. Comparing the 12 months before and after a fall, the most dramatic increase was in community care costs (160%), compared to a 37% increase in social care costs and a 35% increase in acute hospital care costs. While falls patients in this study accounted for slightly more than 1% of Torbay’s over-65 population, in the 12 months that followed a fall, spending on their care accounted for 4% of the whole annual inpatient acute hospital spending, and 4% of the whole local adult social care budget. The authors discuss how linked health and social care data can be used to inform policy and practice. The findings strengthen the case for an integrated response for frail older people at risk of falls. However, to allow comparison of different models of care, other localities need to emulate Torbay’s recording and analysis of whole-system data at the patient level - which, to the authors' knowledge, is the first time that such detailed analysis of the costs in the health and social care system has been carried out in relation to falls patients in England.
(Edited publisher abstract)
Subject terms:
falls, older people, costs, care pathways, NHS, social care, community care;
ROYAL COLLEGE OF PHYSICIANS. Clinical Effectiveness and Evaluation Unit
Publisher:
Healthcare Commission
Publication year:
2007
Pagination:
121p.
Place of publication:
London
... and carried out by the Royal College Of Physicians' Clinical Effectiveness and Evaluation Unit (CEEu), shows that most PCTs and Trusts were nowhere near meeting national standards and guidelines from NICE, SIGN and the National Service Framework for Older People on the care and prevention of falls
The first national clinical audit to investigate the care received by patients who have fallen and fractured bones (hip, wrist, arm, pelvis or spine) shows that an inadequate service is being provided by most local health services, and that there are unacceptable variations of care across PCTs and Trusts in England, Northern Ireland and Wales. The audit, commissioned by the Healthcare Commission and carried out by the Royal College Of Physicians' Clinical Effectiveness and Evaluation Unit (CEEu), shows that most PCTs and Trusts were nowhere near meeting national standards and guidelines from NICE, SIGN and the National Service Framework for Older People on the care and prevention of falls
Falls cause more harm and distress to NHS inpatients every year. One hospital's implementation of a regional FallSafe project has increased the use of evidence-based measures to prevent falls. The project relied on a network of falls champions, who were nurses or health care assistants who taught and inspired their colleagues to implement care bundles.
(Publisher abstract)
Falls cause more harm and distress to NHS inpatients every year. One hospital's implementation of a regional FallSafe project has increased the use of evidence-based measures to prevent falls. The project relied on a network of falls champions, who were nurses or health care assistants who taught and inspired their colleagues to implement care bundles.
(Publisher abstract)
Subject terms:
falls, prevention, NHS, staff, nurses, nursing, patients, evidence-based practice, health care;
Journal of Integrated Care, 18(2), April 2010, pp.33-40.
Publisher:
Emerald
... in their own home. The scheme also installed safety features into homes aimed at preventing falls, a responsibility that social services failed to provide within reasonable timescales. The authors conclude that the more informed policy makers are about practical solutions the better the situation and choices for older people.
This article, drawing on the evaluation of a handyperson service which augments health and social services to enable older frail people to remain living at home, considers current trends and policy, and asks why practical help is under-valued by professionals caring for older people. While policy has promoted needs led services, research has found that services are risk-led and responsive to crisis rather than need. The Birmingham Handyperson Service, established as a response to unmet needs, and eventually receiving health and social service funding, provides free home maintenance by the organisation, with service users being required to meet the cost of materials. The authors surveyed 75 older people receiving the service. Findings highlighted the: cost effectiveness, especially to the NHS (where the cost of a single hip fracture offsets the schemes annual running cost); fears of older people in letting in strangers; changes to family models; complexity of need; recognition of dependency; health and gender inequality; and training and responsibility of the handy-people. Nearly 83% of the respondents thought that the Handyperson scheme was an important reason they were still living in their own home. The scheme also installed safety features into homes aimed at preventing falls, a responsibility that social services failed to provide within reasonable timescales. The authors conclude that the more informed policy makers are about practical solutions the better the situation and choices for older people.
Subject terms:
home help, home improvements, independence, NHS, older people, prevention, unmet need, very old people, cost effectiveness, falls;
DH CARE NETWORKS. Telecare Learning and Improvement Network
Publisher:
DH Care Networks. Telecare Learning and Improvement Network
Publication year:
2008
Pagination:
16p.
Place of publication:
London
Since the time of data collection (April/May 2008), a number of other Local Authority/Primary Care Trust partnerships have been developing telehealth programmes. These have not been included in this report but can be identified through updates in the telecare newsletters. Some of the responses indicate that the service had not commenced at the time of the data collection but were planned for 2008 and beyond. The responses generally relate to small pilots (between 5 and 50 users) at the time of data collection apart from Kent (over 200). The main disease areas covered include heart failure, COPD and diabetes. There are case study and local evaluation reports of positive benefits for individual users (increased re-assurance and improved quality of life) and some indications from professional judgment that hospital admissions may have been prevented.
Since the time of data collection (April/May 2008), a number of other Local Authority/Primary Care Trust partnerships have been developing telehealth programmes. These have not been included in this report but can be identified through updates in the telecare newsletters. Some of the responses indicate that the service had not commenced at the time of the data collection but were planned for 2008 and beyond. The responses generally relate to small pilots (between 5 and 50 users) at the time of data collection apart from Kent (over 200). The main disease areas covered include heart failure, COPD and diabetes. There are case study and local evaluation reports of positive benefits for individual users (increased re-assurance and improved quality of life) and some indications from professional judgment that hospital admissions may have been prevented.
Subject terms:
information technology, long term conditions, mental health care, NHS, older people, telecare, adults, assistive technology, dementia, falls;