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Wiltshire Falls System Design Sue Odams Consultant Public Health Wiltshire Council 27 th March 2014.
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Transcript of Wiltshire Falls System Design Sue Odams Consultant Public Health Wiltshire Council 27 th March 2014.
Wiltshire Falls System DesignSue Odams
Consultant Public Health
Wiltshire Council
27th March 2014
Presentation
• Background- Wiltshire• Falls in Wiltshire• Current System• BVHC Work• Current position• Future
Background
• Large county• Population: 470,981 (2011 Census)• Retirement age population:
– 18.2% Wiltshire– 19.6% South West– 16.3% England– Ageing fast!
Falls in Wiltshire
• Falls and injuries:– 65+: better than England average– 65-79: better than England average– 80+: not significantly different from England average
• Hip fractures 65+ and 80+:– Not significantly different from England average
Patient Fall At Home
Ambulance
Hospital
A&E
GP- Risk Assessment
Medical Falls Clinic
NT Falls Clinic
Fracture Clinic
RHRD Fracture
Liaison Clinic
NT Falls Clinic
Medical Falls Clinic
1:1 at patient's
homeStrength
and balance classes
Admission
NT Falls Clinic Risk
Assessment
Medical Falls Clinic
Strength and balance
classes1:1 at
patient's home
GP Surgery- Risk
Assessment
No referral
Social Care/District
Nurse
GP- Risk Assessment
Call 111 111 Algorhythm
Current Wiltshire Falls System
• Communication and Documentation:– ‘Passport’– IT systems– Whose responsibility?
• Patchy coverage and multiple referral possibilities:– Neighbourhood Teams– Medical Falls Clinics– Community Falls Clinics– Fracture Liaison Service?
Better Value Healthcare
• Public Health Lead• Core Group
– Public Health– CCG– Healthwatch– AWP– Social Care
• 5 Domains• Falls Group
BVHC Principles• Define the scope of the system• Define the population to be served• Reach agreement on the aim and objectives of the service• For each objective to find one or more criteria• For each of the criteria identify levels of performance that can be used as quality
standards• Identify all the resources used in the system, thus creating a system budget• Define all the partners so that they need to be engaged in a Clinical Network• Produce a system specification • Prepare a plan to build the system
BVHC Falls Workshops
• First– BVHC philosophy– Scope– Population– Objectives
• Second– Revamp of objectives
• Third (9th April)– Development of criteria
Current Situation• Define the scope of the system• Define the population to be served• Reach agreement on the aim and objectives of the service• For each objective to find one or more criteria• For each of the criteria identify levels of performance that can be used as quality
standards• Identify all the resources used in the system, thus creating a system budget• Define all the partners so that they need to be engaged in a Clinical Network• Produce a system specification • Prepare a plan to build the system
Wiltshire Falls Group Objectives• Increase awareness of falling, promote physical activity in older people- increase number of
people self accessing services• To identify those at high risk of significant falls (incorporating osteoporosis) and appropriately
manage• To diagnose and treat quickly (need timeframe) accurately (on clear pathway)
– Those who have fallen (known and unknown)– Those at risk of falling
• In order to:– Reduce the number of #NOFs– Maintain the independence those who have fallen/at risk of falling in their own home/place
of residence– Reduce the number of people calling ambulance service having fallen– Reduce the number of people admitted to nursing homes as a result of falling– Improve quality of life- those at risk and those who have fallen (confidence etc)
Future
• Understanding of system• Patient pathway• Monitoring and evaluation of system• Fit into other priorities and objectives?• Other BVHC domains
Questions?