On this page you’ll find information on the Gloucestershire Falls pathway, available training and education resources.

On this page...

Hospitals and inpatient settings:

Community settings:

  • Care to Learn eLearning via Gloucestershire Health & Care NHS Foundation Trust

Care home staff:

Also excellent for professionals to review and use in practice.

  • Upon initial contact with a health care professional, the following Falls Prevention Care Pathway must be used: (G-Care – G-Care – Falls prevention (glos.nhs.uk)) (Appendix 2)
  • All patients over 65 should be asked about their falls history including the frequency, context and characteristics of the fall/s and screening of their gait
  • For individuals reporting blacking outs or suspected transient loss of consciousness or syncope manage according to clinical urgency including urgent medical care or onward referral to syncope clinic
  • For individuals, reporting no fall or a single fall with no concerns about balance or walking, at risk of falling or fear of falling or sedentary and deconditioned – offer information about keeping strong, active and ageing well.
  • They can be encouraged to contact Strong & Steady 0300 421 6241, strongandsteady@ghc.nhs.uk for personalised advice.

For individuals reporting a single fall with abnormal gait and balance or other health concerns offer referral to appropriate service.   This may include completing a multifactorial falls risk assessment and a subsequent, individualised Falls Risk Management Plan (FRMP), depending on the underlying health concerns.

Individuals reporting two or more falls in the previous two months  may require referral to either Falls Assessment & Education Service (FAES) or GP referral to Medical Falls Clinic.

Patients do not need to be referred to FAES or Medical falls Clinic if their falls risks have been identified and an appropriate falls risk management plan (FRMP) has been agreed or if the patient is unable to attend an outpatient clinic appointment.

  • Ensure a partnership approach is used, involving the patient in planning their own care.
  • Ensure the Falls risk management plan is clearly documented and discussed as part of any onward referral.

All service users to be offered an appropriate copy of the Falls prevention information.

The purposes of the assessment are to address the mechanism of the fall, the consequences of the fall (e.g., injury, functional deficits, psychological effects such as concerns about falling), and the identification of potentially contributing fall risk factors.

  • Acute medical condition
  • Frailty
  • Warning sign of unidentified underlying condition
  • Take into consideration perception of falls, causes, future risks and how they can be prevented
  • Gait & balance
  • Muscle strength
  • Medications
  • Cardiovascular disorders (including OH)
  • Dizziness
  • Functional ability & walking aids
  • Vision & Hearing
  • Environmental hazards
  • Pain
  • Musculoskeletal disorders
  • Foot problems & footwear
  • Neurocognitive disorders
  • Neurological disorders
  • Concerns about falling
  • Underlying diseases
  • Nutritional status
  • Alcohol consumption
  • Urinary incontinence
  • Different dependent on the risk stratification
  • Person centred
  • Dependent on the risks identified during assessment
  • Multidomain intervention
  • Education
  • Exercise and physical activity
  • Medication
  • Cardiovascular
  • Environmental
  • Concerns about falling
  • Vision
  • Vitamin D
  • Vestibular interventions
  • Countywide specialist service providing secondary falls prevention assessments, advice and clinical & non-clinical education.
  • Team consists of Team Lead, Clinical Specialist Physiotherapists, Health & Exercise Practitioners and Administrators
  • Work closely with the medical falls clinic provided by GHNHSFT.
  • Provide public education as Strong & Steady
  • We are not an urgent response service but provide assessment of adults who have had recurrent falls.
  • Referral criteria – 2 or more falls in the last 6 months, Gloucestershire GP
  • Referrals routes – wide range of referrers including self referral.
  • Triage – to ensure not an urgent requirement and meets our referral criteria. Falls history is key to outcome.
  • Multifactorial falls specialist assessment as per NICE 161 guidelines & RCP/BGS guidelines including vestibular assessments (onward referral for medical review if required).
  • Provision of management plan and basic rehabilitation plan
  • Onward referral for further strength and balance rehabilitation via core services including Active Balance Class or community exercise interventions.
  • We provide advice and support to other clinical teams such as the Integrated Care Teams.
  • We provide falls training for wide ranging clinical staff for example – Occupational Therapy falls response staff, community dementia nurses, rehabilitation support workers.
  • We have written an eLearning package that is available via Care to Learn – add link

Historically we have:

  • Taught care staff as part of essentials of health
  • Supported the Care home teams

Strong & Steady

QI project to increase uptake of public education.

  • group talks & supporting other public engagement events
  • Falls Awareness Week
  • individual responses from the Strong & Steady Contact cards

Assessment

  • Do you want to stay strong and steady?
  • Do you have difficulty getting off the floor or out of a chair?
  • Do you feel unsafe moving around?
  • Are you concerned about slips, trips or falling over?

If you answered YES to any of the above or want to know more about staying strong and steady or preventing falls

Contact

Telephone: 0300 421 6241
Email: StrongandSteady@ghc.nhs.uk
Website: https://www.ageuk.org.uk/somerset/activities-and-events/stay-strong-stay-steady

Able like Mable

<INSERT FLOWCHART HERE – PROCESS IF YOU’VE HAD ONE FALL, TWO FALLS, THREE OR MORE FALLS>

Contact

Falls Assessment & Education Service
Telephone: 0300 421 6241
Fax: 0300 421 6871
Email: falls@ghc.nhs.uk

Page last updated: 1 August 2024