One in three older people fall every year, and younger people are at risk of falls too. The causes of falls are multiple and the effects can be significant and wide ranging. However falls are everyone’s business, and all of us can help reduce them within our roles.
Assistance to Get Up Off the Floor
For patients who are uninjured but stuck on the floor, follow the fallen uninjured person pathway to access urgent support to help them off the floor. This service is provided by the Assistive Technology Enabled Care (ATEC 24) monitoring and response team on behalf of the Edinburgh Health and Social Care Partnership.
Risk of Admission
If the patient is at imminent risk of hospital admission due to falls within the next 4 hours follow the Urgent Therapy and Social Care pathway by checking the referral criteria. Call the Flow Centre 8:30am to 2pm on 0300 013 4000 option 1 and 4, or Social Care Direct on 0131 200 2324 outwith these times.
Edinburgh Falls Prevention Pathway
If you are working with a person of any adult age living in the community who has had recent falls, worsening or increasing falls, or is at risk of falls, you can support them by following the Edinburgh Falls Prevention Pathway January 2024 for Health Care Professionals Pathways for other groups (Social Care & Social Work and Third Sector) can be found lower down on this page under Guidelines, Policies and Strategy.
Multifactorial Falls Assessment and Rehabilitation at Home
For patients who would benefit from a multifactorial falls assessment at home call Social Care Direct – details of a Clinician only falls Telephone Number can be found on the intranet falls page. A practitioner working within a therapy team will aim to visit within 10 days or quicker, depending on urgency. The practitioner will work with the patients to carry out a multifactorial assessment of both the person and their home environment for falls risks. They will advise and support with an individualised balance, strength, gait and functional rehabilitation programme. They can also arrange provision of equipment or minor adaptations to improve independence with daily activities and complete onward referrals to further reduce falls risk.
Signposting
- People living in the community: If you are looking to signpost a person living in the community to local information that can help reduce their risk of falls, you can use some of the links in the Edinburgh Falls Prevention Pathway, or direct them to this page: https://www.edinburghhsc.scot/longtermconditions/falls-support/
- People living in care homes: If you are looking to signpost a care home resident or their next of kin to information about falls, you can direct them to this page: https://www.edinburghhsc.scot/longtermconditions/fallsincarehomes/
Strength and Balance
- Steady Steps classes: This is a service provided by Edinburgh Leisure within their centres. You can find background information, referral criteria, a referral form and a patient information leaflet.
- Be Able: For patients suitable for referral to Be Able strength, balance and mobility input at home, you can find more information including referral criteria and make an online referral.
Day Hospital
For patients who would benefit from combined medical, nursing and rehabilitation assessments to reduce their falls risk this can be arranged through referral to the three day hospitals.
Patients in the South of Edinburgh can be referred to Liberton Day Hospital via SCI Gateway. Patients in the North West of Edinburgh can be referred to WGH MOE ARC via SCI Gateway. Patients in the North East of Edinburgh can be referred to LCTC MOE OPRA via SCI Gateway.
Specialist Input to Reduce Falls Risk Factors
If the patient requires specialist input to reduce their identified falls risk factors you can find links to a range of specialist services such as podiatry, dietetics, speech and language therapy, continence services, substance misuse, auditory services, visual services, chronic pain, mental health, community stroke, progressive neurological conditions, occupational therapy or musculoskeletal physiotherapy within Edinburgh on the Edinburgh Falls Prevention Pathway January 2024 for Health Care Professionals or on RefHelp.
Medication Review
For patients with medication that may be affecting their falls risk a medication review can be provided by he Primary Care Team (GP, Primary Care Pharmacist) or by NHS Lothian Community Pharmacy Champions by emailing PCPteam@nhslothian.scot.nhs.uk.
Community Alarms
For patients that might benefit from a community alarm, this allows 24/7 support from the ATEC 24 monitoring and response team. A referral can be made via Social Care Direct.
Community Equipment
For patients who would benefit from assessment for equipment to live independently, more support is available. For minor adaptations such as grabrails, handrails and bannisters, a self-referral can be made via the online form. If an assessment for other community equipment or larger adaptations is indicated, a referral can be made via Social Care Direct. Patients can also return items to the Community Equipment Service and get help in the event of equipment breakdown.
Care Home Residents
If you are working with a care home resident who has had recent falls, worsening or increasing falls, or is at risk of falls, referrals to services that can support the resident with a range of falls risk factors can be made by the care home, the GP, or a range of professionals. to the services here: https://services.nhslothian.scot/CareHomes/Pages/default.asp
Guidelines, Policies and Strategy
- Edinburgh Falls Prevention Pathway January 2024 for Social Work and Social Care
- Edinburgh Falls Prevention Pathway January 2024 for Third Sector Practitioners
- NICE Guidelines 161 Falls in Older People: Assessing Risk and Prevention 2013
- Nice Guidelines 232 Head injury: assessment and early management
- SIGN Guidelines 142 Management of Osteoporosis and Prevention of Fragility Fractures 2021
- World Guidelines for Falls Prevention for Older Adults- A Global Initiative 2022
- Scottish Government Healthcare Framework for Adults Living in Care Homes- My Health, My Care, My Home 2022
Falls Engagement and Training Sessions
If you would like a 40min interactive MS Teams engagement/training session on the Edinburgh Falls Prevention Pathway for a multi-disciplinary clinical team within your healthcare setting in Edinburgh please contact both Jo Gordon (Community Falls Coordinator) and Dene Walker (Project Support Officer) on jo.gordon@nhslothian.scot.nhs.uk and dene.walker@nhslothian.scot.nhs.uk – Please note that we are Edinburgh based and have improvement and strategic rather than clinical roles. Thank you.
