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Falls and Fragility Fracture Prevention in Scotland
National Falls and Bone Health Symposium
Dublin, 30th October 2018
Ann Murray
Lead, Falls Programme
Active & Independent Living Programme
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Falls and Fragility Fracture Prevention in Scotland This session
• the Scottish context
• our story so far
• the next chapter
[photograph]
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Setting the scene Scotland at a glance
•Population 5.3 million
•Health and social care devolved
to Scottish Government
•14 territorial NHS boards
• 31 Health and Social Care
Partnerships since April 2016
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Setting the Scene The National Falls Programme (2010 – present): what are we trying to accomplish?
To reduce the personal, system and societal costs
associated with falls in Scotland by…
… every Health and Social Care Partnership area in
Scotland having a local integrated falls and
fragility fracture pathway, so that …
… people have the opportunity to receive the right
information, advice, care and/or support
wherever they are on their journey of care. Jacqui Lunday Johnstone
Chief Health Professions Officer
Scottish Government
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Setting the scene Collaborations and Partnerships
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The story so far…
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Our story so far: Leadership Local leaders (with senior organisational support)
http://www.knowledge.scot.nhs.uk/fallsandbonehealth.aspx
Learning sessions,
meetings and events
WebEx sessions
Online Falls and
Bone Health
Community
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http://www.scotland.gov.uk/Publications/2014/10/9431
Supporting people to:
be informed about falls and
bone health
keep active, steady & well
have a safe & enabling home
and community
connect with their community
Our story so far: Co-creating a shared vision The Up and About Pathway
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Our story so far: A Framework for Action
Focus in preventing recurrent falls and accumulative consequences
A Framework for Action for Scotland http://www.scotland.gov.uk/Publications/2014/10/9431
•For health and social care services and partner
organisations.
•16 core actions representing the minimum standard of
information, care or support across the four stages of the
Up and About pathway.
•Underpinned by clinical guidelines and tacit knowledge.
https://www.nice.org.uk/guidance/cg161
http://www.bgs.org.uk/index.php?option=com_content&view=article&i
d=320:bgsagsfalls2010&catid=47:fallsandbones&Itemid=307
http://agile.csp.org.uk/resources
http://www.cot.co.uk/sites/default/files/publications/public/Falls-
guideline.pdf
http://www.sign.ac.uk/guidelines/fulltext/142/
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Our story so far: A Framework for Action Collaborations and Partnerships
Care Homes
Improvement
Collaborative
2015-16
Scottish Ambulance Service
Falls and Frailty Pathways
Improvement Collaborative
2016-18
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Our story so far: Measurement Falls Integration Indicator
http://www.gov.scot/Topics/Health/Policy/Adult-Health-
SocialCare-Integration/Outcomes/Indicators Information Services Division, NSS, 2017/18
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Our story so far: Identifying synergies and opportunities Knitting
Technology
Enabled Care Dementia Care Housing Polypharmacy &
pharmaceutical
care
Social isolation
and loneliness out soon
Physical Activity
Frailty [photograph]
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The next chapter A collaborative, whole system approach, reaching more people with early prevention.
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#takethebalancechallenge
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A focus on earlier prevention: the Balance Challenge Campaign
The ‘Super Six’
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https://www.nhsinform.scot/aboutfalls
Issued through Age
Scotland Helpline
(0800 12 44 222)
https://fallsassistant.org.uk/
A focus on earlier prevention: the Balance Challenge Campaign
Signposting to resources to support self management
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www.facebook.com/CAPAprogramme
https://twitter.com/capaprogramme
www.capa.scot
The Care… about physical activity improvement programme includes:
•Working with care homes, care at home, housing support and other support services for older people to
equip staff to promote more movement / physical activity every day, in ways that are meaningful to the
person.
•Care Inspectorate staff development.
A focus on earlier prevention: the Care Sector
Care… about physical activity (CAPA)
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www.facebook.com/CAPAprogramme
https://twitter.com/capaprogramme
www.capa.scot
On average, Berg Balance Scale improved significantly from baseline to 6-weeks
(p≤0.05) and baseline to 20-weeks (p≤0.05), meaning individuals significantly
reduced their likelihood of falls at 20-weeks.
A focus on earlier prevention: the Care Sector
Care… about physical activity (CAPA)
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http://www.capa.scot/
A focus on earlier prevention: the Care Sector
Care… about physical activity (CAPA)
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https://www.pathsforall.org.uk/pfa-home
•Supported over 200 community-based schemes and over 200
work places to develop walks.
•85% of the Scottish population live within 2 miles of a Paths for
All health walk
A focus on earlier prevention: the Third Sector
Paths for All
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http://www.roarforlife.org/
A focus on earlier prevention: the Care Sector
Roar Connections for Life
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In conclusion…
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“For every complex problem there is an answer that is clear, simple … and wrong.”
H.L Mencken
In conclusion…
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“People have different learning styles, different levels of education and
income and different expectations of life.
The method used to motivate 73 year old, life-scunnered Betty to invest
in herself will be completely different to the approach needed with the
fabulously feisty 92 year old Iris.”
Nicola Hanssen, General Manager, Roar Connections for Life
In conclusion…
scunnered (Scottish verb): feel disgust or strong dislike
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Thank you for listening
For more information, please contact:
Ann Murray
Falls Lead, Active and Independent Living Programme
http://www.knowledge.scot.nhs.uk/fallsandbonehealth/the-national-falls-programme
[photograph]