DERBYSHIRE: New falls service success, say health chiefs

Frail and elderly patients who fall over at home are now far less likely to need hospital treatment, thanks to a pioneering mobile service, health chiefs have claimed.

Of the 115 patients seen by the falls partnership service in the north of Derbyshire from its launch in November to the end of January, 67 (or 58 per cent) did not have to go to hospital.

The reduction in avoidable hospital admissions has saved more than £190,000, representing nearly half of the expected annual running costs of the service funded by NHS Hardwick and North Derbyshire Clinical Commissioning Groups (CCGs).

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At that rate, the service will pay for itself twice over in the current financial year. And the service looks set to get even busier now it is also taking 999 calls.

Dr Ruth Cooper, clinical lead for the falls service, said: “Falling over can cause distress, pain and injury. It damages confidence and undermines independence. In some cases, it can even result in death. Falls have a financial impact too and cost the NHS more than £2.3bn a year.

“With the number of falls increasing as the population gets older, this service provides rapid access to healthcare and equipment that will improve quality of life for our patients and allow them to continue living independently at home.”

Dr Steve Lloyd, Chair of NHS Hardwick CCG, said: “As the service becomes embedded and people become more aware of it, we should see more and more activity, and lots more patients avoiding a hospital admission and being treated in their own homes.”

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The service operates Monday to Saturday between 6.30am and 6.30pm, and is a partnership between Derbyshire Community Health Services (DCHS) NHS Trust, East Midlands Ambulance Service NHS Trust and Chesterfield Royal Hospital NHS Foundation Trust.

The service is live across the Hardwick area and in the Chesterfield and North East Derbyshire localities of North Derbyshire. It will be rolled out across the rest of North Derbyshire during 2014, widening access to an innovative service that delivers care closer to home.

Where possible, people who have fallen are treated at home by an integrated team of highly-skilled paramedics, occupational therapists and physiotherapists with the support of a consultant geriatrician.

People can access the service via 999, 111, the out-of-hours GP service provided by Derbyshire Health United, and the Community Careline Service.

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Kavi Berry, who manages the Falls Partnership Service for DCHS, said: “Patients have been very positive about the new falls service. They are delighted when they don’t need to go into hospital but can be treated at home.

“As well as the good feedback from families, our crews find it very rewarding to be able to offer early intervention in patients’ own homes, giving them the best chance of maintaining their mobility and independence.”

Dawn Booker, falls partnership service paramedic, said: “I am now aware of the other pathways available to the patient and, with our team’s support and input, am helping reduce the need to take patients to accident and emergency departments.”

Occupational therapist Rebekah Eakins said: “I enjoy being at the front line of the service, helping patients at the point that it really matters, and being able to take an holistic approach that meets a multitude of needs at the same time.”

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Dr Ben Milton, Chair of NHS North Derbyshire CCG, added: “The falls partnership service is a shining example of health services working together smartly to provide first-class community care while achieving important efficiencies in these economically challenging times.

“Not only does the service provide rapid home treatment, it also reduces the risk of future falls by advising patients and their carers on making changes around the house. In fact, every patient seen so far has had a home environment assessment carried out.”

Seventy two per cent of patients have been referred for after care from professionals including a GP, community physiotherapist or occupational therapist, podiatrist, social worker, district nurse or the area’s falls clinic.

Falls are the most common cause of emergency hospital admission for the 100,000 plus patients served by NHS Hardwick CCG. In the year to last April, 1,995 Hardwick patients were admitted to hospital following a fall. Of these, 128 (or six per cent) had suffered a fractured neck of femur.