1. No Needless Falls & Fractures Sue Harriman, Executive Lead Jill Phipps, Project Manager Jill.Phipps@southernhealth.nhs.uk

2. No Needless Falls & Fractures Reducing variation across the patch Benchmarking project – comparing Oxford and Buckinghamshire Falls services Reducing falls FallSafe project Elearning for falls ‘Getting to zero’ Fracture prevention FRISCy Partnership working with the National Osteoporosis Society Winchester fragility fracture audit Falls Network Peer support, sharing best practice Raising awareness

3. Benchmarking falls services project – key findings Effective interventions for falls prevention Variety of falls pathways Staffing, training, referrals & triage, exercise “The falls prevention services in Oxford and Buckinghamshire are well grounded in research evidence and their leadership is keeping up to date with the most recent research and with the alternative models that exist across the country.” Dr Todor Proykov January 2012

4. FallSafe A 2 year quality improvement project funded by the Patient Safety Federation & the Health Foundation, led by the RCP, hosted in 16 sites across South Central “Can a nurse influence others on the ward to embed falls prevention into regular ward practice using a quality improvement approach?” Training and support to a nurse lead on each ward Care bundle – 1 element introduced every 4-6 weeks Clinical steering group

5. First monthLast month 1 Call Bell91%98% 2 Cognitive screen50%78% 3 Fear of falling29%68% 4 History of falls81%89% 5 Lying Standing BP25%50% 6 Medication review42%84% 7 Night sedation not given78%87% 8 Safe footwear91%97% 9 Urine dip-test63%78%

6. Adjusting for reporting changes Staff asked about last fallAt baselineAfter Total who remembered a recent fall 85%72% Total who were certain it was reported 56%85% Total who thought it had probably been reported 18%8% Total who doubted if it got reported at all 26%7%

7. Adjustments for under-reporting In period one (before), the reported falls rate on the FallSafe wards was 9.98 falls per 1000 bed days. Given at that time, staff were confident that only 56% of falls were being reported, the actual falls rate was likely to be around 17.82. In period three (after), the reported falls rate on the FallSafe wards was 11.57 falls per 1000 bed days. Given at that time, staff were confident that 85% of falls were being reported, the actual falls rate was likely to be around 13.61. This suggests actual falls may have reduced by around 25%

9. ‘Getting to Zero’ Joint working to reduce falls, skin breakdown and improve nutrition Quality improvement methodology using intentional rounding Frontline staff from acute and community sites across South Central, including 3 Care Homes

10. Fracture Prevention FRISCy Fracture prevention/liaison services E -FRAP reporting system Partnership working with National Osteoporosis Society Winchester fragility fracture audit

11. South Central falls Network Peer support Sharing good practice Raising awareness