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

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300

Po

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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