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

ann.murray3@nhs.net

Falls and Fragility Fracture Prevention in Scotland This session

• the Scottish context

• our story so far

• the next chapter

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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

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

Setting the scene Collaborations and Partnerships

The story so far…

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

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

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/

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

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

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]

The next chapter A collaborative, whole system approach, reaching more people with early prevention.

#takethebalancechallenge

A focus on earlier prevention: the Balance Challenge Campaign

The ‘Super Six’

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

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)

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)

http://www.capa.scot/

A focus on earlier prevention: the Care Sector

Care… about physical activity (CAPA)

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

http://www.roarforlife.org/

A focus on earlier prevention: the Care Sector

Roar Connections for Life

In conclusion…

“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

Thank you for listening

For more information, please contact:

Ann Murray

Falls Lead, Active and Independent Living Programme

ann.murray3@nhs.net

http://www.knowledge.scot.nhs.uk/fallsandbonehealth/the-national-falls-programme

[photograph]