A landmark report into the management and prevention of falls among over 65-year olds in the Isle of Man has been published by the Department of Health and Social Care.
The first major review of provision has been carried out in three key settings: hospitals and inpatient units, care homes and the wider community. It identifies good practice, highlights where change is required and sets out priorities for the future, in the light of the Island’s growing elderly population.
The report concludes that there is much good practice at Noble’s Hospital and other inpatient units such as Isle of Man Hospice, where the majority of current guidelines for falls management and prevention, set by the National Institute for Clinical Excellence (NICE), are met. The majority of respondents routinely assessed patients at risk of falling, considering factors such as visual and cognitive impairment, mobility problems, medication, balance and having a history of falls.
Government and privately-run care homes are meeting some NICE standards while working towards achieving others. However, the report highlights gaps in provision in Community Care services - a vast category spanning a wide range of healthcare professionals, from those based in GP surgeries and community clinics to dietitians, language therapists and opticians.
Surveys were carried out among staff and stakeholders in each of the three settings in September and October 2017. Their replies have helped build an Island-wide ‘where we are now’ baseline to guide future policy decisions. Responses were benchmarked against both NICE recommendations and the West Midlands Quality Review Standards (WMQRS).
The report sets out recommendations for improvement across the board and in specific settings. On-Island staff training and a standardised set of documents are identified as key needs, alongside a call for an integrated approach to falls prevention among all care providers.
The falls and fragility fracture nurse post at Noble’s is a key strength for the hospital, ensuring awareness among staff of factors which can lead to a fall. The report suggests a similar community-based role could help reduce falls by ensuring best practice is embedded in care systems for older people, and it suggests pharmacists could play a role, through front line contact with the public.
Public health strategist Dawn Henley said:
‘This report should be seen as a positive step. It paves the way for an integrated falls strategy and an action plan to ensure high standards in all settings.'
She added:
‘Falls can cause injuries such as bruising, cuts, breaks and even serious head injuries. The vast majority of hip fractures are caused by falling, but it is difficult to quantify the impact a fall can have on an individual’s mobility and confidence. We need to make falls everyone’s business and build a service that can meet the demands of a growing elderly population. Reducing falls in this age group will improve quality of life for those aged 65 and over, and is in line with our aim to deliver longer, healthier lives.’
The full report: A review of the Island’s falls provision based on best practice is available to download on the government website.
