NHS Aylesbury Vale Clinical Commissioning Group
NHS Chiltern Clinical Commissioning Group
Falls prevention: a case for change
Dr Raj Thakkar BSc (Hons) MBBS MRCGP MRCP
Clinical Commissioning Director
Chiltern & Aylesbury Vale CCGs
Thames Valley Primary Care Cardiac Lead for HF and AF Oxford AHSN
What are the consequences of falls?
• Annual NHS cost £2.3 billion.
• >4 million beds days (England)
• Doubles the hospital length of stay
• 70,000 hip fractures
• Unsustainable for health economy
• Vast social care bill
National
• Personal injury e.g. osteoporotic fracture
• 30-73% left with loss of confidence/independence
• Mortality (10% annual, 14000 deaths/year)
• Leading injurious cause of death in elderly
Patient
• Huge Pressure
Family/Carers
>50% falls are preventable
Population growth
Source: Office for National Statistics (2016)
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027
To
tal P
op
ula
tio
n
Year
A Chart Showing Chiltern CCG’s and Aylesbury Vale CCG’s Population Projection.
Population Aged 65-79
Population Aged 80 and over
Falls increase with age
50,000
55,000
60,000
65,000
70,000
75,000
80,000
85,000
90,000
95,000
100,000
0
50
100
150
200
250
300
Po
pu
lati
on
No
. o
f F
alls
Bucks CCGs Falls Age 65+ vs Bucks Registered Population Age 65+
Bucks CCGs Falls 65+ Bucks CCGs Reg Pop 65+
Do Nothing Scenario – not an option
Ageing Population
Increase in Falls Activity
Increase in Falls cost
Strategy: Bucks
• Falls Group
• Population Education
• Care Homes
• Vaccines
• QIS :
– Screening, Meds Opt etc.
Strategy: Bucks
Working with organisations
in Buckinghamshire
to promote
falls prevention
Metrics
0
50
100
150
200
250
300
0
50
100
150
200
250
300
A chart showing Bucks CCGs admissions for Falls in any diagnosis position for people aged 65+ with baseline
Bucks CCGs Falls 65+
Baseline
Metrics
0
100
200
300
400
500
600
700
800
Apr-
14
Ma
y-1
4
Jun-1
4
Jul-1
4
Aug-1
4
Sep-1
4
Oct-
14
No
v-1
4
De
c-1
4
Jan-1
5
Feb
-15
Ma
r-1
5
Apr-
15
Ma
y-1
5
Jun-1
5
Jul-1
5
Aug-1
5
Sep-1
5
Oct-
15
No
v-1
5
De
c-1
5
Jan-1
6
Feb
-16
Ma
r-1
6
Apr-
16
Ma
y-1
6
Jun-1
6
Jul-1
6
Aug-1
6
Sep-1
6
Oct-
16
Nu
mb
er
of
Calls t
o S
CA
S r
ela
tin
g t
o f
alls
Month and Year
A Chart Showing the Number of Calls to SCAS Relating to Falls Made by Aylesbury and Chiltern CCG
Number of Calls to SCAS
Baseline
Benefits of a TV wide falls strategy
• SCAS
• Cost
• Capacity in health
• Social care
Resilience
Patient
Family/Carers
Next steps for Thames Valley
Raise as a priority
System Wide Approach
Commitment from all CCGs