Following the success of the first North Yorkshire falls conference in September 2014, a follow up event was held on 23 October 2015 at the Pavilions in Harrogate. Documents, including presentations made at the conference, can be downloaded from the right hand side of the page.
Summary and background
In North Yorkshire there is a strong strategic drive to prevent illness and disability in the population and therefore reduce the burden on health and social care services. There is also a linked strategic push to join up working between primary, secondary, acute and social care services to improve the effectiveness and cost effectiveness of care and, therefore ultimately, patient outcomes.
In the Better Care Fund submission (based on the North Yorkshire county footprint) each economy was able to choose a local indicator that illustrated the aspiration for improved working across health and social care. As part of the broader county-wide programme to improve health outcomes for people in North Yorkshire by co-ordinating and integrating services, reducing falls was identified as a key marker of how well the health and social care economy was functioning together.
The Better Care Fund indicator for reducing falls has been taken from the Public Health Outcomes Framework indicator 2.24i, emergency hospital admissions for falls injuries in persons aged 65 and over, directly age-sex standardised rate per 100,000. From the Public Health Outcomes Framework documentation:
"Falls are the largest cause of emergency hospital admissions for older people, and significantly impact on long term outcomes, e.g. being a major precipitant of people moving from their own home to long-term nursing or residential care.
A measure that reflects the success of services in preventing falls will give an indication of how the NHS, public health and social care are working together to tackle issues locally."
In the Better Care Fund submission partners agreed the following statement:
"North Yorkshire was in the top ten per cent of best performers amongst county and unitary authorities for the standardised rate of injuries due to falls in 2011-12; however we project that this rate of injuries due to falls will increase rapidly over the coming years. Between 2011-12 and 2015-16, North Yorkshire is expected to see an 11 per cent increase in the number of people over the age of 65. Our ambition ensures that this increase in population does not place an increase in demand on services - in absolute numbers, we hope to decrease falls by 29 (1.4 per cent) from our current baseline and 11 per cent from the projected increase in injuries due to falls."
In September 2014 we held a stakeholder event in York with the aim of drawing "the ideal" whole-system pathway for preventing and managing falls across York and North Yorkshire, and establishing what it would take in each locality to reach that "ideal".
Since then a falls co-ordinator, based in the public health department at North Yorkshire County Council, has been appointed to support taking the work on falls forward across the county.
A number of "products" have been developed including:
- Assessment tools / data sets;
- Quality standards for hospitals and extended care settings;
- A draft gap analysis of interventions;
- A draft performance framework; and
- We are in the early stages of developing business cases for Fracture Liaison Services.
In order to progress this work participants were asked to look at the products to test the benefits and obstacles associated with them.
A second workshop asked delegates to look at how can we overcome the commissioning / contracting barriers to turn the vision for falls services into a reality?