Falls, Tech

Spotlight on Falls

 

Falls are one of the most feared health emergencies for older people and their families. In our three-part series, we will be shining a spotlight on falls, the changes we aspire to make and the impact these will have in reducing falls. We begin by looking at how falls impact older people and the implications for a person when they fall.

The potential to have a fall is something many older people and their families dread. Whether the person lives at home, is in hospital or in a care home, having a fall can have significant and far-reaching consequences. It’s something many health and social care staff also fear and often find difficult to mitigate against and manage. 

 

What do we know about falls?

The 2018 ‘NICE impact report on falls and fragility fractures’ said:

Older people are more likely to fall. They are also more likely to suffer significant consequences, such as a loss of independence and confidence, leading to physical and mental deterioration and frailty. This increases the risk of a person experiencing multimorbidity, which is when a person has 2 or more long-term health conditions. It can also increase their risk of further falls and fractures.

In 2015/16, NHS Improvement reported that 204,269 inpatient falls were voluntarily reported by acute trusts, with a fall rate of 2.8 falls per 100 patients. However, many falls occur at home and go unreported, so the true incidence of all falls is unknown. It is estimated that approximately 30% of people older than 65 fall at least once a year; this is around 3 million people in England.

The 2022 Age and Ageing Journal published the first ‘World guidelines for falls prevention and management for older adults’ that said: 

Falls occur at all ages and are an inevitable part of a bipedal gait and physical activity. They occur in 30% of adults aged over 65 years annually, for whom the consequences are more serious, despite concerted efforts of researchers and clinicians to understand, assess and manage their risks and causes. In addition to personal distress, falls and fall-related injuries are a serious health care problem because of their association with subsequent morbidity, disability, hospitalisation, institutionalisation and mortality.

In Europe, total deaths and disability-adjusted life years due to falls have increased steadily since 1990. The Global Burden of Disease study reported nearly 17 million years of life lost from falls in 2017. Related societal and economic consequences are substantial. In high-income countries, approximately 1% of health care costs are fall-related expenditures.

Note: NICE (National Institute for Health and Care Excellence) are currently updating their guidance on Falls and their new recommendations will be published in August 2024.

 

Falls and care homes

With these statistics in mind our Associate Director, Preet Shergill, has made falls the subject of his NHS Digital Academy TOPOL Fellowship (TOPOL Fellowships were borne out of the 2019 Review conducted by Eric Topol MD entitled ‘Preparing the healthcare workforce to deliver the digital future’). In his first blog for the NHS Digital Academy about his fellowship entitled ‘Empowering social care through digital innovation: My Topol Digital Fellowship journey’ Preet said:

The public health data highlights the urgent need for falls prevention strategies, given the impending exponential growth in the 85+ age group. In my local county of Buckinghamshire, the number of people over 85 is projected to rise by 78% over the next 12 years. The total annual cost of fragility fractures to the UK, including social care, is estimated at £4.4 billion.

 

What are the current challenges around falls?

As we go into the autumn and winter seasons, falls join flu, Covid and many other seasonal challenges making NHS-related headlines every year. Falls outside are more likely in cold and icy conditions, and falls inside become more common when people are unwell with infections and more confused, tired or struggling with their balance.

Once a person has a fall, shock and distress are highly likely, making the psychological impact immediate. The physical consequences can, at worst, mean broken bones – hip fractures are especially common and often life-changing or life-shortening – and, if the person has hit their head, potentially the consequences can be fatal. 

Even if these worst-case scenarios are avoided, a fall often means going to hospital for a precautionary scan and tests, an in-patient stay may be needed, pain may be difficult to assess and control, and bruising and any cuts can take a long time to heal. 

With extended waiting times for ambulances, overstretched A and E departments, shortages of beds on wards, and the difficulties for an older person or a person with dementia when they are in an unfamiliar environment (that can often lead to further falls, loss of independence, weight loss and incontinence), going to hospital alone can be a traumatic experience.

Even if a person’s physical injuries heal, the physiological ones often remain. The person may repeatedly think about how they fell and what the cause was. They may become fearful of walking, or lose confidence in maintaining aspects of their independence that they feel may have either led to their fall or could lead to another fall. It then becomes a vicious circle of reduced mobility, with the physical consequences of pressure ulcer risks and greater chances of infections like UTI’s, and greater dependence, which can often erode feelings of self-worth and self-esteem.

 

Falls matter to everyone

Because falls have such a massive impact on the lives of people who fall and their families, we believe they are a vital issue for us to understand more about. We need to find innovative ways to prevent falls and, should a fall still occur, manage a person’s recovery as effectively as possible through modern rehabilitation techniques – like our personalised, at-home physio service – to ensure the best quality of life for our residents.

We will never be able to prevent every fall, or indeed the physical and psychological effects a person may be living with from a fall prior to moving into a Peverel Court Care Home. What we can do, however, is change the narrative and our approaches to find new solutions and ways of thinking.

 

What’s next?

In our second blog of this series, we will hear from some of our residents, families, staff and other healthcare professionals about their personal and professional experiences of falls. We will also discuss how digital transformation can lead to a positive impact in reducing falls.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire. Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business. Providing exceptional, personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

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24/7 GP access for our staff

24/7 online GP service for staff at Peverel Court Care

 

With a recent study revealing that NHS patients are now waiting on average nearly 15 days to see a GP for a routine appointment, we examine how we’re helping our staff with their own health needs.

 

Access to GPs has seldom made more headlines than it has of late. A report published on the Pulse – considered the leading publication for GPs in the UK – highlighted that in a recent survey, over 20% of the 900 GPs who responded said that their patients faced an average wait for a routine appointment of over three weeks. More than one in 20 stated it was more than four weeks.

Another story from Pulse earlier this year focused on the fact GP surgeries across the UK have been shutting their doors in record numbers. In 2018, 138 surgeries closed, compared with just 18 in 2013. Much of this is believed to be the result of underfunding, although leading figures in the sector have complained that GPs are overworked and stressed, leading more to exit the profession or reduce their hours.

More recently, a study by the University of Manchester found that GP partners’ income had decreased by around 10% in real terms over the period from 2008 to 2017.  This has come against the backdrop of GP workloads increasing by around 20% over the same period. Taken together, it is believed that this “may have contributed to current recruitment and retention problems”. 

 

The expert view

Prof Helen Stokes-Lampard, chair of the Royal College of General Practitioners, was quoted as saying: 

Our patients should be able to see a GP when they need to – and the fact that this is becoming increasingly difficult is frustrating for GPs and their teams, just as we know it is for patients. People are waiting too long for routine appointments, and the concern is that non-serious conditions might deteriorate, or patients give up trying to see the GP and we miss signs of serious illness early, when it could be dealt with simply and more cost effectively in primary care.

All of this comes in the wake of the 2015 election pledge by the Government to add an additional 5000 GPs by 2020; a pledge which they are struggling to meet. However, this promise was questioned by many, including Dr Chaand Nagpaul, chair of the BMA’s GPs committee, who said at the time:

Delivering 5,000 extra GPs in five years, when training a GP takes 10 years, was a practical impossibility that was never going to be achieved. It was a pledge that also ignored the fact that one third of GPs are planning to retire by 2020, and the current medical graduates do not want to join an overworked, underfunded service, with more than 400 GP trainee posts left unfilled last year.

 

Our solution to the GP access problem

Given the challenges faced by both the GPs and their patients, it’s hardly surprising that juggling a working day with the sparse availability of appointments has never been more difficult for patients; and in particular those who are shift workers – like many of our staff.

That’s why, at Peverel Court Care we have invested in a service which provides 24/7 online access to a GP for our staff. Whilst we appreciate that for certain conditions, a visit to the local surgery may still be required, we hope that the online service we’ve provided can, for many, give them an alternative to the lengthy NHS waiting times.

We recognise the fantastic work that our team do in providing first rate levels of care for our residents. So we believe that it’s only right and proper to do all we can to help them maintain their own health and wellbeing. Therefore, the introduction of the GP service is just one of many recruitment and retention initiatives we have in store to help our staff realise how valued they are by the Peverel Court Care management team. We hope that these small gestures of our appreciation can help make their work-life balance that little bit easier.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire: Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business, providing personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

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