Wiltshire Falls System Design
Sue Odams
Consultant Public Health
Wiltshire Council
27th March 2014
Presentation
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Background- Wiltshire
Falls in Wiltshire
Current System
BVHC Work
Current position
Future
Background
• Large county
• Population: 470,981 (2011 Census)
• Retirement age population:
– 18.2% Wiltshire
– 19.6% South West
– 16.3% England
– Ageing fast!
Falls in Wiltshire
• Falls and injuries:
– 65+: better than England average
– 65-79: better than England average
– 80+: not significantly different from England average
• Hip fractures 65+ and 80+:
– Not significantly different from England average
GP- Risk
Assessment
Medical
Falls Clinic
NT Falls
Clinic
Fracture Clinic
Hospital
A&E
RHRD
Fracture
Liaison Clinic
NT Falls
Clinic
Admission
Medical
Falls Clinic
Ambulance
NT Falls
Clinic Risk
Assessment
GP SurgeryRisk
Assessment
Patient Fall
At Home
No referral
Social
Care/District
Nurse
GP- Risk
Assessment
Call 111
111
Algorhythm
Strength
and balance
classes
1:1 at
patient's
home
Medical
Falls Clinic
1:1 at
patient's
home
Strength
and balance
classes
Current Wiltshire Falls System
• Communication and Documentation:
– ‘Passport’
– IT systems
– Whose responsibility?
• Patchy coverage and multiple referral possibilities:
– Neighbourhood Teams
– Medical Falls Clinics
– Community Falls Clinics
– Fracture Liaison Service?
Better Value Healthcare
• Public Health Lead
• Core Group
– Public Health
– CCG
– Healthwatch
– AWP
– Social Care
• 5 Domains
• Falls Group
BVHC Principles
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Define the scope of the system
Define the population to be served
Reach agreement on the aim and objectives of the service
For each objective to find one or more criteria
For each of the criteria identify levels of performance that can be used as quality
standards
Identify all the resources used in the system, thus creating a system budget
Define all the partners so that they need to be engaged in a Clinical Network
Produce a system specification
Prepare a plan to build the system
BVHC Falls Workshops
• First
– BVHC philosophy
– Scope
– Population
– Objectives
• Second
– Revamp of objectives
• Third (9th April)
– Development of criteria
Current Situation
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Define the scope of the system
Define the population to be served
Reach agreement on the aim and objectives of the service
For each objective to find one or more criteria
For each of the criteria identify levels of performance that can be used as quality
standards
Identify all the resources used in the system, thus creating a system budget
Define all the partners so that they need to be engaged in a Clinical Network
Produce a system specification
Prepare a plan to build the system
Wiltshire Falls Group Objectives
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Increase awareness of falling, promote physical activity in older people- increase number of
people self accessing services
To identify those at high risk of significant falls (incorporating osteoporosis) and appropriately
manage
To diagnose and treat quickly (need timeframe) accurately (on clear pathway)
– Those who have fallen (known and unknown)
– Those at risk of falling
In order to:
– Reduce the number of #NOFs
– Maintain the independence those who have fallen/at risk of falling in their own home/place
of residence
– Reduce the number of people calling ambulance service having fallen
– Reduce the number of people admitted to nursing homes as a result of falling
– Improve quality of life- those at risk and those who have fallen (confidence etc)
Future
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Understanding of system
Patient pathway
Monitoring and evaluation of system
Fit into other priorities and objectives?
Other BVHC domains