Promoting evidence informed service development: a study of falls services in Cheshire

Abstract

Background: This study investigated two initiatives for preventing falls in Cheshire: public events to raise population awareness about falls and ways of preventing falls, a programme of falls assessments and falls prevention classes. Aim: The study aimed to support service development by generating local learning about: the falls risk status of older people attending the public events and their use of services for preventing falls, the efficiency and effectiveness of the falls programme. Methods: A local adaptation of an instrument used in similar research was administered to assess the falls risk status of older people attending the public events. This instrument captures data about the age, sex, gait, sensory deficit, falls history, current medication, medical history, mobility and living situation of respondents. Attendees were also asked about their current use of falls services. To evaluate the falls programme data were collected about the characteristics and referral sources of service users and, for users of the falls prevention classes: their mobility and balance on joining and completing the classes; their fear of falling and confidence linked to falls at the start of the classes and six months later; the number of falls they experienced in the six months before starting and after completing the classes. Findings: Of the 453 attendees screened, 64.3% were at medium risk of falling or above and 34.3% had suffered previous falls. None were accessing falls prevention services. During its first year, 324 individuals were referred to the falls programme. Overall, among those individuals who provided data for analysis, there was a statistically significant improvement in the 'clinical' outcomes assessed and a statistically significant reduction in the occurrence of falls. The majority of respondents indicated that they achieved an improved confidence linked to falls and a reduced fear of falling. Conclusions: Studies of this type can provide a valuable contribution to local learning but the characteristics of the research collaborations developed can affect study designs and the quality of the information generated.

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“…For example, frequent fallers were not always directed to falls prevention services even though they can reduce the burden of recurrent falls (Beech et al . , Dickinson et al . ).…”

“…Services for preventing health crises were underused because individuals were slow to access care following accidents or when feeling unwell and because health professionals failed to inform patients about preventative services. For example, frequent fallers were not always directed to falls prevention services even though they can reduce the burden of recurrent falls (Beech et al 2010.…”

“…falls prevention schemes (Beech et al . ); schemes to provide more proactive care for people with long‐term conditions (Russell et al . , Sheaff et al .…”

“…preventing an emergency attendance in the longer term [e.g. falls prevention schemes (Beech et al 2010); schemes to provide more proactive care for people with long-term conditions (Russell et al 2009, Sheaff et al 2009; diverting hospital emergency referrals/ attendances [e.g. rapid response teams (Stevenson & Spencer 2002, Beech et al 2004]; reducing acute lengths of stay [e.g.…”