Sue Dewhurst from PHE, shares the latest information around "Falls Prevention"

1. Falls Prevention- everyone’s
business
Sue Dewhirst-Population health services manager, Public Health
England, Coordinator of National Falls Prevention Coordination
Group (NFPCG)

2. What I will cover
-What is the National Falls Prevention Coordination Group (NFPCG)?
-Falls-risk factors
-National picture-current data
-Falls and Fractures consensus statement and resources
-Key interventions-eg. Strength and balance exercise, home adaptations
-NFPCG programme and developments
-Who can help? A whole system approach
-Making it happen
Falls prevention video: https://learn.nes.nhs.scot/23390/falls-preventionFalls Prevention-a national perspective

3. NFPCG
National Falls Prevention Coordination Group
• Set up since 2016
• Now has over 35 member organisations
• Brings together representatives from national organisations, academia, 3rd
sector
• Hosted by Public Health England
• Meets 3 times a year in London
• Provides leadership, enables dissemination of good practice, supports data
collection, informs skills development, influences policy, facilitates task and
finish groups
Falls Prevention-a national perspective

4. Falls-the risk factors
There are a very large number of falls risk factors (over 400). Significant ones
include:
• a history of falls
• muscle weakness
• poor balance
• visual impairment
• environmental hazards
• polypharmacy and the use of psychotropic and anti-arrhythmic medicines,
• + a number of specific conditions including cognitive impairment, diabetes,
high alcohol consumption, incontinence, Parkinson’s disease and stroke.
Falls Prevention-a national perspective

5. 5
Falls - National picture
For people aged 60+, women are more
likely to fall than men
Fall hazards in the home
cost the NHS
£435 million
a year
29.1% 23.5%
Emergency admissions for falls
are higher for older people
Falls Prevention-a national perspective

6. Falls and fracture consensus
• National Falls Prevention Coordination Group (NFPCG), since 2016
• Falls and fractures consensus statement (published February 2017) -
commissioner focussed (but useful to all!) – details key interventions,
approaches to commissioning plus national commitment for support
• Falls and fracture consensus statement resource pack (July 2017) –
comprehensive set of resources and tools to support commissioning and
delivery including frailty section and commissioners checklist
• Takes a life course and whole system approach
• https://www.gov.uk/government/publications/falls-and-fractures-consensus-
statement
Falls Prevention-a national perspective

7. Key interventions- a whole system approach
• Life course risk factor reduction
• Case finding and risk assessment
• Strength and balance exercise programmes
• Healthy homes, including home adaptations
• High-risk care environments
• Fracture liaison services (FLS)
• Collaborative care for severe injury
Falls Prevention-a national perspective

8. Falls Prevention-a national perspective

9. Home HazardsAssessment
What does the evidence say?
• Gillespie et al, Cochrane Library systematic review, 2012. Home hazard
assessment and modification (HAM) interventions delivered by an OT
reduced the rate of falls by 31% and the number of people falling by 21%.
• ‘Adaptations without delay’ report (RCOT, 2019)-raises issue of lack of
capacity
• Updated Cochrane Library environmental modifications review due July
2020
NICE Guidance (QS86)-Home hazards assessment and safety interventions
Older people who have received treatment in hospital following a fall should be
offered a home hazard assessment and safety intervention/modifications by
a suitably trained healthcare professional.
Falls Prevention-a national perspective

10. NFPCG Programme 2019/ 2020
Evidence briefing-Multi-factorial falls prevention interventions (February 2019)
Contributed to resources from North of England Falls Prevention in Care Homes
Strength and Balance Roadshows in South East and North of England, PHE and
the Centre for Ageing Better-March 2019
Contributed to resource Preventing falls in people with learning disabilities
(August 2019)
Strength & Balance Quality Markers (published 29th July 2019)
Falls and Fractures Prevention-All Our Health (updated January 2020)
Home adaptations NFPCG meeting September 2019, PHE Healthcare Public
Health newsletter articles on Home adaptations and Adaptations without
Delay (October 2019) and the Disabled Facilities Grant (January 2020)
Falls Prevention-a national perspective

11. In development
• All Our Health e-learning on e-lFH, due for publication in April 2020
• PHE Healthcare Public Health newsletter articles, includes falls prevention
• National Falls framework for ambulance services, including prevention,
based on the Welsh model
• Consulting with NIHR to develop falls prevention research questions
• Future NFPCG meetings 2020 themes include:
Adult Social Care and Dementia, Fractures
Falls Prevention-a national perspective

12. Who can help?Awhole system
approach
Falls Prevention-a national perspective

13. Making it happen
• Evidence based interventions –Cochrane reviews
• Data –Primary care data, electronic frailty index, emergency services data
• Quality improvement –the Strength & Balance Quality Markers paper may
help, data collection important
• Effective governance at all levels
• The Falls Consensus statement and resource pack may help
• Make falls prevention everyone’s business!
Falls Prevention-a national perspective

14. Thanks!
THANK YOU FOR LISTENING!!
Contact: Sue.Dewhirst@phe.gov.uk
Falls Prevention-a national perspective