Services

Specialist

Care Pathways and Guidelines
Older People

Falls Prevention

The National Service Framework for Older People, published in March 2001, set out a model for service provision for falls and bone health. By April 2005 all local health and social services systems should have established an integrated falls service to meet the standards and actions as set out in the NSF.

In the UK, 30% of the population over 65 years, and 50% of the population over 80 years will fall each year. The associated mortality, physical injury, loss of function and loss of independence from a fall are great. Hip fracture, which occurs in approximately 60.000 people who fall, costs the NHS approximately £1.7 billion and is associated with up to 14,000 deaths.

Although the majority of falls are reported to result in no harm, even falls without injury can be upsetting and lead to loss of confidence, increased length of stay and an increased likelihood of discharge to residential or nursing home care.

Prevention of falls, particularly injurious falls, remains a key Department of Health policy focus as emphasised by Professor Ian Philp in his progress report (Recipe for Care-Not a Single Ingredient, DH, 2007) wherein he stated that putting in place fully integrated falls prevention services could prevent up to 400 hip fractures annually in each strategic health authority.

The Haringey falls prevention care pathway and risk assessment tool are incorporated within the Trust’s Falls Prevention Policy. The policy was developed using the NSF standards, NICE clinical guidelines and a large evidence base on falls prevention initiatives.

Haringey Falls Prevention Care Pathway (for older people aged 65+)

Older people in contact with healthcare professionals should be asked routinely whether they have fallen in the past year and asked about the frequency, context and characteristics of the fall(s) (NICE CG21). The falls prevention care pathway guides staff on when and how to identify older people at risk of falls using a falls risk assessment tool and the referral options for those older people identifed as needing further specialist assessment and interventions.
It is applicable to all directly managed staff as well as to independent contractors.
It was approved by the Clinical Effectiveness Committee and PEC in May 2008.

Falls Risk Assessment Tool (FRAT)

Older people reporting a fall or considered at risk of falling should be screened using the FRAT. This short and simple tool uses 5 questions to identify an older person’s risk of falls. A score of 3 or more indicates someone at high risk of falls and they should be referred to the Haringey Integrated Community Therapy Team for a specialist falls assessment and interventions to reduce their risk factors. Referral options for people scoring 1 or 2 are also included.