Partners and network members

Birmingham is in the worst national quintile for incidence of falls and hip fractures. Birmingham South Central CCG has been piloting an e-frailty tool within GP practices, to understand the needs of their frail population. A new integrated falls pathway is under development, which initially will support falls awareness sessions in libraries. Groups of over-65s who regularly meet at libraries will have opportunities to discover how simple exercises can improve muscle strength, leading to better balance to reduce falls risk, while books and DVDs have also been purchased. Move It or Lose It classes are being set up.

Blackburn with Darwen is a unitary authority in Lancashire, which has higher than average levels of falls among over-65s, and above average rates of a number of long-term health conditions which affect overall health, wellbeing and safety. The area has a well established falls service offering both clinical intervention, and education and activity around reducing the risk of injury. As a local partnership led by Age UK, Blackburn with Darwen has identified that a key local priority is preventing people from falling at all, through prevention education targeted at those identified as at risk of a fall. It has held training courses reaching a wide range of front-line staff from across the public and voluntary sector, and public events to promote activities and information which support the prevention of falls.

A varied programme of speakers and demonstrations featured in the Care Home Excellence event, bringing together local partners in Bolton to focus on falls prevention. Organised by AgeUK Bolton, topics included the use of computer games to improve strength and balance, the importance of footwear and dealing with issues around eyesight. Practical demonstrations of Tai Chi kept delegates on their toes and the session ended with delegates making pledges to improve falls prevention in their care homes.

Falls prevention is part of the Bolton Locality Plan. The variety of partners involved in the programme includes Greater Manchester Fire and Rescue Service, Bolton GP Federation, Bolton CCG, NHS, Bolton Council and new partners such as Red Ninja!, a technology company who are developing a falls risk assessment tool called Safe Steps.

As part of their community intervention, Stand Up, Stay Up local partner Brighton and Hove has produced a video that showcases the many varied activities available to residents that will help to improve strength and balance, as well as featuring local people speaking about how exercise has benefitted them. This is part of a wider programme to develop further opportunities to get involved in activity across the city.

In Brighton and Hove in 2015, over-65s accounted for 13.4 per cent of all residents, and it is predicted that over-65s in the city will increase to 40,100 by 2020. More than a fifth of older residents live in income deprivation and more than a half of all older residents live in the 40 per cent most income-deprived areas in England. In 2014/15, it recorded a higher rate of emergency admissions to hospital for injuries due to falls in people aged over 65compared to the South East region and England, as well as a higher rate of emergency admissions for hip fractures. It is running a preventative intervention to promote healthy, active ageing by engaging local people aged 50-plus in physical activity that improves strength and balance. A Strong and Steady Flash Mob campaign has been launched, helping local people to reduce the risk of falling as they get older.

Bristol is in the worst national quintile for incidence of falls and hip fractures. A falls strategy will be developed to include frailty and dementia. RoSPA funding will be used to train exercise professionals to deliver strength and balance community-based exercise programmes, called Staying Steady, in the city. This will build on a pilot project, which took place a number of years ago, in which 40 people attended classes and reported improved walking and balance scores by 78 per cent. A multi-agency, multi-professional strategic group continues to meet to incorporate a number of evidence-based interventions, which will support a comprehensive falls prevention strategy.

Staying Steady and Strong in Bristol

More than 100 people representing health and social care and community and voluntary sector organisations attended the launch of Bristol's new Staying Steady programme of strength and balance exercise, which helps people lower their risk of falling.

Presentations from RoSPA and the providers delivering Staying Steady outlined the need to support healthy and active ageing. The audience also took part in the 30 second balance challenge!

The ‘stars’ of the afternoon were the attendees of the Greenway Centre’s Staying Steady classes, who spoke about their experiences and benefits of attending the classes, including getting involved in something new, making new friends, enjoying a cup of tea and a catch up after the class and, of course, the exercise!

The programme is now being rolled out in a number of areas of Bristol and people can access the classes by contacting the providers directly (no need for a referral).

Cumbria's population is ageing faster than the rest of the UK – by 2020, nearly 25 per cent will be aged over 65. A countywide multi-agency steering group has been established to develop the Cumbria Falls Prevention Programme. A workshop was held in March 2017 with representatives from health, social care, housing and the voluntary sector to develop a proactive, coordinated and collaborative campaign targeted at older people living in the community. The campaign will include up-to-date information on the prevention of falls that will be made widely available to older people and their carers, and will involve promotion sessions at places that are well attended by older people such as town centres, supermarkets, cafés, bingo halls and community groups. RoSPA delivered training over two days to workers from several different agencies who contribute to falls prevention.

Hammersmith and Fulham is the second-worst borough in London when compared to the city's average for injuries due to falls in people aged over 65. Bishop Creighton House (BCH) is an established voluntary agency which works with community health teams. The Stand Up, Stay Up programme will support partnership working and reduce the number of injuries from falls, giving over-65s increased confidence and reducing social isolation. Elements of a Steady and Stable session will be delivered at the start and end of all BCH classes. It is hoped that popularity will grow and an established Steady and Stable class can be delivered. All volunteers will be taught how to deliver strength and balance training. An outreach programme will also be delivered to older people who are housebound.

Health day highlights falls

Joy Wilson from Bishop Creighton House reports on their recent health day that highlighted falls prevention as well as general health and wellbeing for older people:

"Our BCH Health Day on May 15th was inspired and prompted by our partnership with ROSPA and especially the support we have had through Stand Up Stay Up. We wanted to provide a day that would inspire people towards a more active and healthier lifestyle. Over 180 people attended and we hope they will have found that BCH is a very helpful place to come to.

We were able to use some of our funding from Stand Up Stay Up to help towards the day and we were able to attract partners like the Community Independence Service and the Falls service to attend because of the backing of ROSPA. The feedback form clients and professionals was that the day was very worthwhile and enjoyable. People tried exercise classes for the first time and enjoyed them and said they will come back again. Members of the public also attended a free Nutrition Class which taught healthy eating. Physiotherapists commented that they changed over 10 worn out walking Stick ferrules and through doing blood pressure checks were able to recommend that people visit their GP if they were showing signs of Hypertension or Hypotension.

It was a brilliant day that we will hopefully make an annual feature!"

RoSPA has teamed up with partners in Hampshire to provide a grant for a community intervention led by Hampshire Fire and Rescue Service (HFRS) that will improve falls prevention in the borough of Rushmoor. Falls in the borough are significantly higher than the rest of Hampshire and are higher than the England average in eight out of the nine public health indicators for falls. HFRS has used the grant to equip crews at Rushmoor Fire Station in Farnborough with Quantitative Timed Up and Go (QTUG) devices, which are used to estimate the risk of someone falling and calculating a frailty prediction. It will be used during visits to assess people in their own home and estimate the likelihood of them falling. HFRS is also working with local partners and agencies to create a strong network, allowing residents who have been identified as being at risk to receive quick, accurate signposting and referrals.

The proportion of older people in Northamptonshire is anticipated to increase at a faster rate than other age groups, with the over-65 population predicted to increase by 51 per cent by 2030. Predictive modelling suggests that over a 12-month period in the county, of the current population, 31,757 people will experience a fall, and more than 3,000 will be admitted to hospital as a result of a fall. The local authority is taking a strategic, system-wide approach to falls prevention, and after a consultation and engagement with local people and partner organisations developed a strategic commission framework for the county – Standing Up For Ourselves – which sets out a shared vision with explicit aims and measurable objectives.

Our partners in Northamptonshire have just released a new video which features local resident Gloria describing her experience of falls and the services available in the county to help prevent falls. The video gives plenty of advice on how to prevent falls and although the services described are specific to Northamptonshire it serves as a useful example of one way in which areas are seeking to make their services more accessible.

Networking event hears about Stand Up, Stay Up

By Jim Oram
RoSPA public health project officer

RoSPA’s Stand Up, Stay Up national falls prevention programme was highlighted and promoted at Northamptonshire’s first networking event for the health, social care, private and volunteer sectors. The RoSPA-funded Falls and Bone Health Network Event at Kettering’s Corn Market Exchange attracted dozens of professionals from a number of organisations. The aim of the day was to build networks with local partners who could contribute to, and influence, the countywide falls prevention programme.

Information was given about falls prevention initiatives, including home hazard assessments, community-based Otago exercise sessions, awareness training for frontline staff and web-based resources. A presentation by the National Osteoporosis Society turned the spotlight on bone health programmes and research.

Attendees heard that in Northamptonshire the aim is to make falls everyone’s business and ensure that everyone plays their PART:

Preventing
Assessing
Reducing /Referring
Treating/Undertaking training

A local action plan is being delivered in the county through work with a local Implementation Group of key stakeholders.

A presentation identified the benefits of partnership working:

• Well attended, regular implementation group meetings
• Practical evidence of change – for example, Otago sessions
• Identification of key professionals to become falls prevention “champions”
• Ensuring that falls prevention is embedded in contract expectations.

Delegates pledged to ensure partnership development and strengthened pathways to prevent falls in Northamptonshire.

Pilot pharmacy training goes national

A workshop aimed at increasing the understanding of how pharmacy teams can help to prevent falls is being made available nationally following successful delivery in Northamptonshire.

CPPE (The Centre for Pharmacy Postgraduate Education), in collaboration with Northampton LPC, Northampton County Council and RoSPA, developed the workshop on falls prevention and bone health which was delivered to 32 pharmacy professionals, enabling them to better support patients, identify risks and help prevent falls.

Reducing falls for people with Alzheimer’s

People who suffer from Alzheimer’s Disease are known to be at greater risk from a variety of health issues including falls. Stand Up Stay Up partners in Northamptonshire are addressing this through an initiative to reduce hazards in the homes of people who suffer from the disease. Led by Care and Repair Northamptonshire with support from RoSPA and the Alzheimer’s Society the initiative enables improvements such as fitting grab rails, making steps and walkways more visible and fitting shower seats. Initial findings show that the fear of falling has reduced for most of the clients visited so far.

For example:

Mr B, lives with his wife in own property
Pre-Intervention Fear of Falling: 5 generally, but 9 at front door
Post-Intervention Fear of Falling: 2

Mr B’s main concern was fear of falling when entering the front of the property and our technician assessed for and fitted grab rails to the main entrance; Mr B declined the offer of coloured grab rails, opting for traditional white which he felt showed up well against the brickwork.

Client Mr H, lives with his wife in own property
Pre-Intervention Fear of Falling: 6 (wary)
Post-Intervention Fear of Falling: 2

Mr H was initially referred as needing a grab rail fitted to his shower. Our technician visited to fit the grab rail and carried out a home assessment. The assessment identified that Mr H had problems getting into and out of his house and would greatly benefit from cranked handrails being fitted. Our technician re-visited to carry out this work.

Client Mr E, lives in own property with wife
Pre-Intervention Fear of Falling: 3
Post-Intervention Fear of Falling: 1

Our technician visited and fitted a grab rail to the shower area. He carried out a home assessment which highlighted that Mr E would also benefit from further grab rails, to the top of the stair and to the front entrance. Additionally, there was a paved area to the back garden that required levelling as represented a potential trip hazard. Our technician fitted the grab rails through the RoSPA project, and we provided Mr E with a quote to carry out the levelling works to the garden.

Sandwell has an ageing population, with falls rates that are higher than the national average. The project in the borough is a partnership approach between health professionals, the local authority and the voluntary sector, with the overall aims of increasing co-ordination and understanding of the multiple services available, supporting the community in maintaining healthy active lifestyles, and supporting falls prevention. This will include utilising technology in a more productive way, such as the use of QTUG to measure a person's gait and assess their risk of falling. The project will support the aim of establishing a one-stop resource for all services within the borough for falls management and prevention, developing a more cohesive and comprehensive picture of services available.

A total of 18.5 per cent of the population in Southend-on-Sea are aged over 65, and the rate of falls and hip fractures are higher than the national average. The local authority, health and voluntary sectors are working in partnership on a strategy to reduce falls, to run alongside an accident prevention strategy. This will support interventions through targeted falls risk assessments, and awareness training to at-risk older people, their families and carers who will receive specific prevention advice and support. Falls risk measurements are being carried out through the trial of Electronically Augmented Timed Up-and-Go tests – in the community and in Postural Stability Instructor (Staying Steady) classes – to identify those who are at-risk and formulate bespoke interventions, such as exercise.