Coventry Physiotherapy

Falls Service

02476 237 051

2013

Aims of the Coventry Physiotherapy Falls Service

• Provide a single point of access for patients, carers and health professionals

• Provide timely physiotherapy intervention to assess for and reduce the risk of falls

• Provide advice and education to patients, carers and health professionals

Falls Guidelines

NICE Guidelines CG161 Falls: The Assessment and Prevention of Falls in Older People (June 2013)

• Patient Centred Care • Case/risk identification• Multifactorial falls risk assessment• Multifactorial interventions• Strength and balance training• Education and Information giving • Environmental Adaptations • Professional education

Criteria to attend

• At risk of falling/ previous falls• Over 65 years of age – 91% 70yrs +• Fully weight bearing• Able to understand/comply• Balance/physical cause of falls• Motivated to participate• Cardiovascular stability• Able to attend Newfield House

Access• GP’s ~ 30%

Refer for non medical intervention by Physiotherapy

• UHCW ~ 30%Dr Chaudhry – Falls Clinic (10%)Emergency Department/REACTTherapists on wardsIntegrated discharge teams

• CWPT ~ 30% Locality therapists/Fast Response/Community Matron/District Nurses Coventry Musculoskeletal Service/Podiatry Community Physio CMHT

• Other ~ 10%

Assessment• Multi-factorial assessment

Poly pharmacy Osteoporotic riskCognition Functional ability Footwear ContinenceVision Assessment of home hazardsHearing

Physiotherapy assessment;• Falls History – mechanical, medical, environmental, unexplained• Past medical history and medication • Balance – Validated Outcome Measures; TGUG, Berg Balance, Short FES-I,

EMS.• Muscle Strength, ROM, gait analysis, gait aids, pain, ADL’s.

• Person centred goals – Goal Attainment Scale – Quality Goal • Referral to other services

Assessment

• Environmental assessment questionnaire;– Completed by patient/carer

prior to attending for assessment

– Onward referral onto • Pathway locality Occ. Therapy • OPAL – Environmental

Adaptations • Coventry Integrated Equipment

services

Treatment• Provided with individualised Otago exercise booklet

– Expected to perform exercises 3-4 x week at home

• Patients attend weekly - – Newfield House for a 7 week programme

• Review week 7– Group session - Individual exercise plans– Supervised by physiotherapist and assistant – Strengthening and balance exercises– Backward chaining – Education sessions provided– Discharge Planning

Review

• Patients receive telephone follow-up after 6 months of discharge from service

• Review short FES-I

• Planning

• Patients can contact during this period if having problems/further falls

Physical outcome measures July 2013

improved, on average by 20-30%

OutcomesPatient Satisfaction•100% strongly agree/agree that they were involved with goal planning •100% strongly agree that they would recommend the service to friends and family

•0% in re-attendance at Accident and Emergency due to a mechanical fall•20 % return to reassessment •10 % attend classes again

“The falls classes …gave me reassurance and confidence to go out alone and took

away the vulnerability when going out

alone..”

“My treatment and care was excellent and most helpful as the lessons progressed I became much more confident and sure of myself and my ability to do the exercises.”

Contact Details

• Clare Mee – Community Physiotherapy and Community Neuro Rehab Team Lead – 0300 2000 396

• Claire Murphy – Physiotherapist claire.murphy@covwarkpt.nhs.uk • Hannah Wade – Physiotherapist hannah.wade@covwarkpt.nhs.uk • Donna Barnes – Assistant Practitioner donna.barnes@covwarkpt.nhs.uk