Information
The East Lothian Falls pathway is hosted within the East Lothian Rehabilitation Service (ELRS) and is delivered by a team of physiotherapy practitioners and community care workers. The team has close links with East Lothian Council Emergency Care Service (ECS – team that will lift and settle patients following a fall).
The team’s role is to support patients with therapy input when they have had a fall, at risk of falling or have a fear of falling. Patients will undergo a multifactorial falls assessment, which considers environment, mobility and transfers, balance, technology, footwear/footcare, hearing/eyesight, equipment, medication, bone health, cognition, and continence.
Interventions provided include:
- advice and education regarding falls prevention and management
- walking aids and other equipment to maintain the patient’s abilities to complete essential daily activities at home (either independently or with support of carers/family)
- provision of exercise programmes to maximise strength and balance
- onward referral to audiology/occupational therapy/third sector/social work.
Following individual assessment, patients, where appropriate, will go on to attend a 14 week Falls prevention and management course. The ‘Steady On’ exercise and education programme is designed to help reduce your risk and/or fear of falling by improving your strength, balance, and confidence; whilst increasing your knowledge and understanding of falls.
Classes will run once a week for 14 weeks and will last approx. 90 minutes. During each class patients will practice a range of strength and balance exercises, and once confident, will be asked to practice some of these at home to help get the most out of the programme. These sessions will also include an education session to enable discussion and learning, often delivered by external speakers e.g. pharmacy, podiatry, etc.
Research has found that taking part in a strength and balance exercise programme can reduce the number of falls and fall-related injuries experienced by those who take part; particularly those aged 65 or over. It is hoped that by taking part in the programme in a safe and supportive environment, patients will feel an increased sense of wellbeing, and greater confidence about their balance and walking.
The core hours of the service are Monday – Friday 8am – 4pm
M.A. & C.D.F. 24-09-24
Who can refer:
Primary Care:
GP’s, Practice Nurses, ANP’s with SCI Gateway access
Secondary Care:
MOE Consultants
AHP’s:
Acute Physiotherapists, Community AHP’s within the wider East Lothian Rehabilitation Service
Patients/Carers/Family members:
Self-referral is available to all East Lothian residents
Who to refer:
- Residents of East Lothian
- Fear of falling
- Feeling unstable/reduced balance
- History of falls (injurious or non-injurious)
- Osteoporosis/high fracture risk/family history of osteoporotic fracture
- Cognitively able to independently follow a home exercise programme
Additional considerations for attending the 14-week group delivered programme
- Cognitively able to independently follow instructions within a group environment
- Must have own transport to attend the classes (transport is not provided by the service, but patient can pursue community transport options if required)
Who not to refer:
- Patients who are undergoing extensive investigation for a medical cause to their falls
- Patients who are acutely unwell and at immediate risk of admission, these referrals should be directed to our Prevention of admission service
- Patients with potential undiagnosed significant injury (e.g. acute onset significant back pain with risk of potential fracture)
- Patients with moderate/severe cognitive impairment (unable to follow simple movement instructions in a group setting) – referrer should use own subjective judgement
- Uncontrolled
- Pain
- Angina
- Tachycardia (HR >100bpm)
- Visual or vestibular disturbances
- Hypertension (resting BP >180/100mmHg)
- Acute systemic illness
- Significant drop in blood pressure during exercise
- Unstable or acute heart failure
- Unable to maintain seated upright posture due to neurological deficit
- Recent injurious fall without medical attention
- Poor safety awareness (likely to put themselves or others at risk)
- Hearing impairment AND cognitive impairment
- have an LD diagnosis or complex MH diagnosis – please refer to appropriately aligned teams for input
How to refer:
Primary Care Pathway:
Referrals should be made via SCI Gateway:
AHP – Physiotherapy
East Lothian – East Lothian Community Hospital
LI Physiotherapy
FAO: Falls Team
Secondary Care:
MOE consultants can refer via email to eastlothianphysioreferrals@nhslothian.scot.nhs.uk
AHPs:
Email referrals accepted to: eastlothianphysioreferrals@nhslothian.scot.nhs.uk
Patient Self-Referral:
Patient/family member/carer can call ELRS Single Point of Contact Phoneline on 0300 3680680 to self-refer for a falls assessment
East Lothian Rehabilitation Service | East Lothian Council ELRS Digital Platform with advice, resources, and external links to support self-management and self-assessment for equipment.
Falls Support and Education – NHS Lothian | Staff NHS Lothian intranet site with links to falls services across Lothian
