An Overview of Falls Assessment Clinics in Gloucestershire

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An Overview of Falls Assessment Clinics in
Gloucestershire
Denise Frost Irene Hardisty
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• Despite the good mechanisms in place for
  identifying falls, it is not clear how widely
  used or effective they are, as the numbers
  attending falls clinics are surprisingly low
  (median 5 per week in consultant physician led
  clinics) considering that about 10,000 falls
  occur annually in the average sized PCT.
• National Audit of the Organisation of Services
  for Falls and Bone Health for Older People 2006

The National Perspective
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Gloucestershire Falls Services

• Clinics
• Clinics rural and urban
• Leading professionals vary
• Collaborative working practices
• There are significant variations in how Falls
  Clinics are funded
• Patients
• On average, 2-3 patients seen in each clinic
• Patient groups predominantly female over the age
  of 75
• We estimate that about 700 patients are seen
  annually
• Appointments can take anywhere up to 2½ hours

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9 Clinics Countywide
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The Falls Clinics
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Referral Protocols

• Referrals from a wide range of professionals, but
  mostly from GPs
• Time from referral to assessment varies anywhere
  between 2-8 weeks
• Inappropriate referrals are being made
• Links are being made in some areas with AE,
  hospital wards and fracture clinics, but these
  are inconsistent
• Ambulance services have no strategy for referring
  patients

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Services provided at Clinics

• Elderly Care Clinics

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Towards an understanding of the bigger picture

• Total number of patients who have fallen
  unknown!

?
228 patientsseen inFAC
571 ambulancecallouts
548 hospital admissions
?
?
June, July and August 2007
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Issues for consideration (1)

• Standardisation of
• Referral procedures
• Referrals from ambulance services
• Screening procedures
• Paperwork
• Access to a physician
• Waiting times
• Patient experience at a clinic
• Funding streams

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Issues for consideration (2)

• Equity of service provision
• Identification of fallers
• Funding streams
• Developing sustainable pathways
• Location of clinics defined by need
• Links with AE, wards and fracture clinics
• Assessments in primary care
• Doing things differently, e.g. using care homes

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Active Balance Classes (1)

• Referrals mostly from FACs
• Waiting times anywhere from immediate start 10
  weeks
• Transport is an issue in some areas
• Classes are either on a rolling programme or run
  in blocks
• Many have an educational component
• 60 completion rate

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Active Balance Classes (2)

• Initial improvement in strength and balance
• Improvement is not sustained if activities are
  not continued
• Access to community activities limited
• Anecdotal evidence from patients suggests that
  this type of activity is beneficial

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Issues for consideration

• Transport issues
• How can mobility be maintained following the
  Active Balance Classes?
• Making links with community based activities that
  are appropriate to needs and affordable

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Thank you for listening

• We are based at the Triservices and can be
  contacted
• On global email
• or
• Telephone [phone]