SUMMARY

Output from Falls and Fragility Fracture Consensus and Commitment Workshop Edinburgh, 29th May 2018

For a copy of the full report or to comment, please contact Ann Murray, Falls Lead at ann.murray3@nhs.net

What outcomes did participants want to see as a result of implementing the strategy?

More people are being

supported to age well through

better relationships and

connections between local

people, communities, services

and organisations.

More people are aware of

where they can get

information, advice or

personalised support to age

well and avoid harm from falls

and osteoporosis.

More people are

participating in regular

exercise to maintain and/or

improve muscle strength and

balance, and are moving

more.

Early prevention and ageing

well is accepted as a cross-

policy issue by authorities,

and this is reflected in

planning and allocation of

funds.

Early prevention is given

more priority, and this is

reflected in the allocation of

resources.

Ageing well and avoiding

harm from falls is considered

in the planning, development

and improvement of housing

and outdoor spaces.

More people (in contact with

older people)

understand how they can

contribute to supporting

people to age well and avoid

harm from falls and

osteoporosis, and take

action to do so.

Data and local intelligence

are used to better

understand how to improve

support and services, and if

new ways of working are

making a difference.

More services are coproduced

with people with lived

experience and the wider

community.

There is less unwarranted

variation in the availability

and quality of

statutory/public services that

support falls and fragility

fracture prevention and

management.

Services take the time to

listen to the person and have

a truly shared conversation

about how they can best

support them to age well and

avoid harm from falls and

fragility fractures.

More people believe that

falls and fragility fractures

can be prevented.

Participants said the strategy needs to…

articulate a coherent approach to preventing and managing falls and preventing fragility fractures.

be for everyone and in plain English.

focus on the outcomes that ‘we’ want to see.

demonstrate ‘joined up thinking’ and ‘joined up action’.

identify key actions that will be taken (and by who).

propose a mechanism for monitoring progress in relation to both taking forward the actions and delivering the outcomes.

recognise that ultimately, to reduce the impact of falls and osteoporosis a ‘through life’ wellness approach is needed.

clearly explain links between ageing well, falls and fragility fractures and other national policies, strategies and priorities.

think long term, and explain that new evidence is emerging for how best we support, enable and empower people to age well, avoiding frailty, falls

and fragility fractures, and new technologies are becoming available – so we have to be flexible.

be linked to the Health and Wellbeing Outcomes.

learn from past achievements and also things that have not worked so well, and recognise that to get different outcomes we will need to do some

things differently.

contribute to reducing health inequalities.

have the people of Scotland at its centre. It will recognise that what matters to a person needs to be the foremost consideration, and that people

need to take responsibility for their own health and wellbeing, with support when it is required.

share examples of approaches that work well.

Better engagement with the

public around ageing and

living well Enable more people to

be more physically

active

Enable more people

to participate in

exercise for falls

prevention and bone

health

Enable and support more

people to maintain their

independence

Enable and support more people to keep

connected

Better meet the needs of people living with

learning disabilities, dementia and sight

impairment

Provide age-

friendly

community spaces

and housing

Enable more people to

have good nutrition and

hydration

Recognise,

understand and

address sensory loss

Promote the importance of

Vitamin D

WHAT participants said we need to do

Supporting people to age well and avoid frailty, falls and fractures

HOW participants said we should do it

Community-based

support

Use language that is

inclusive and positive

Use technology as an

enabler

A national campaign

Promote and

support

positive risk

taking

Have a more joined

up approach

Coproduction

Support the workforce to

work differently

Use data to target support and resources

Improve processes

Themes in bold were those most endorsed.

Identifying people at risk of falls and fragility fractures

Response and management at the time of a fall

Participants said we need to… Participants said we need to…

Have a more joined up

approach

Support the role of families,

carers and the public

Consider enablers

to improving our

response and

management at the

time of a fall

Provide an

integrated

response at the

time of a fall

Improve follow-up after

the initial response

Agree who has

responsibility

for providing a

‘responder’

service

Support the work force to do the right thing

Better use

technology

enabled care as an

enabler

Improve awareness of who to

call at the time of a fall

Improve our

approach to

identifying

risk

Link risk

identification of

frailty and falls

Build capacity to manage the

demand generated by risk

identification

Work with people who are well-

placed to identify people at risk

Make the

most of good

opportunities

to identify risk

Improve care

and support

after a person

at risk has

been

identified

Have a more joined

up approach

Support the public and our

workforce to identify risk

Explore new ways to

identify risk

Agree the role of GPs and GP

Practices in identifying risk

Themes in bold were those most endorsed.

Have a more joined-up

approach

Agree roles and

contributions to coordinated

management and support

Improve support for people going

home after a fall-related hospital

stay

Have more of a focus on the

person

Provide effective

interventions to

prevent fragility

fractures

Better use technology as an

enabler

Improve processes that currently

prevent pathways working

Empower people to take control

Provide effective

interventions to prevent

and manage falls

Support the workforce to do

the right thing

Improve access to ‘specialist’

services

Optimise recovery following

a fall

Strengthen the

role of housing

Agree our approach to

improving the way we do

things

Coordinated assessment, tailored prevention (including prevention of recurrent falls) and

management of falls and fragility fractures (more ‘specialist’ support)

Themes in bold were those most endorsed.

Participants said we need to…

Organisations, Networks, Groups and Programmes Represented

Scottish Community Safety Network

Scottish Federation of Housing Associations

Scottish Government

Scottish Older People’s Assembly

Scottish Patient Safety Programme, Acute Care Portfolio, Healthcare Improvement

Scotland

Scottish Prison Service

Scottish Podiatry Managers

Scottish Public Health Network

Seniors Together

Social Work Scotland Practice Network – Physical Disability and Sensory Impairment

Society and College of Radiographers

Sporta Scotland

Technology Enabled Care Network

University of Stirling

A representative from Glasgow Caledonian University was unable to attend, but provided

their views in advance of the workshop.

Aberdeen HSCP

Aberdeenshire Council

Angus HSCP

NHS Ayrshire and Arran

Dundee HSCP

East Dunbartonshire HSCP

East Lothian HSCP

Edinburgh City HSCP

Fife HSCP

NHS Greater Glasgow and Clyde

NHS Lothian

Midlothian HSCP

NHS Ayrshire and Arran

NHS Dumfries and Galloway

NHS Forth Valley

NHS Grampian

NHS Highland

NHS Lanarkshire

NHS Orkney

Active and Independent Living Programme

Age Scotland

AGILE

Allied Health Professions Directors’ Group

Alzheimer Scotland

British and Irish Orthoptic Society

British Geriatrics Society (Scotland)

British Dietetic Association

Care About Physical Activity Improvement Programme, the Care Inspectorate

Care Inspectorate

Carers Scotland

Coalition of Care and Support Providers Scotland

College of Paramedics

College of Optometrists

College of Podiatry

Care and Repair Scotland

Focus on Dementia, Healthcare Improvement Scotland

Hanover Housing Association

Health and Social Care Alliance

Home Energy Scotland

HSCP Falls Leads’ Network

Living Well in Communities, Healthcare Improvement Scotland

NHS 24

NHS Education Scotland

NHS Health Scotland

National Osteoporosis Society

Osteoporosis/Fracture Liaison Practitioners’ Network

Paths for All

Physiotherapy Scottish Board of the Chartered Society of Physiotherapy

Roar – Connections for Life

Place, Home and Housing, Healthcare Improvement Scotland

RNIB

Royal Society for the Prevention of Accidents

Royal College of Occupational Therapy Falls Forum

Royal College of Occupational Therapy Scottish Board

Royal College of Nursing

Scottish Ambulance Service

Scottish Care

NHS Tayside

Perth and Kinross HSCP

Renfrewshire HSCP

South Ayrshire

South Lanarkshire HSCP

South Lanarkshire Council

West Dunbartonshire HSCP

West Lothian Council