Denise Elliott, Operations Manager

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• Denise Elliott, Operations Manager
• Northumberland Care Trust

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What is Fishnets?
In 2005 Northumberland Care Trust successfully
bid for a proportion of the Partnership for
Older People Projects grant.
Partnerships for Older People Projects is a new
initiative being led by the Department of Health.
The Department is providing 60m ring-fenced
funding, to council-based partnerships over the
years 2006/07 (Year 1) and 2007/08 (Year 2) to
set up innovative pilot projects.
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Northumberland FISHNETS
will help older people keep FIT, INVOLVED, SAFE
and HEALTHY, through investment in sustainable
community NETWORKS.
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• It will address health, social and environmental
  factors to support older peoples wish to
  maintain independence, quality of life and
  inclusion in society.
• This will be achieved by
• Reducing emergency hospital
• admissions
• Reducing the number of falls leading
• to fractures and hospital treatment
• Increasing the number of people
• helped to continue to live at home

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• through a comprehensive prevention programme
• from universal primary prevention,
• to targeted interventions for those most at
• risk of falls,
• delivered through inclusive partnerships
• using community-based initiatives.

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Why Falls? Personal Cost

• 30 of over 65s and 50 of over 85s fall once a
  year
• Every 5 hours an older person dies as a result of
  a fall
• After a hip fracture 50 lose independence and
  25 die
• 40 Care Home admissions are the result of a fall

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Why Falls? - Financial Cost

• The estimated cost of a single hip fracture,
  assuming survival following fracture and spending
  a year in long stay residential care, is
  estimated at 25,424.
• Parrott S, University of York 2000

Northumberland 2003/4 - 455 NoF Cost over two
years 9.1 million
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Why Falls? - Strategy

• Opportunity to address a weak area in NSF Older
  People building on Falls Collaborative
• Economic no brainer
• Develop a model for including older people as
  participants in planning and service
  delivery-another weak area
• Basic idea to build services/opportunities to
  deliver the multi factoral interventions -NICE
  guidance on Falls

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Fishnets - what exactly does it do?
Targeted
Information /website
Technology /call centre
Intermediate care
Accreditation
Physical activity /lifestyle
Home handy person /HIA
OPPG/ Community involvement
Targeted intervention
Primary prevention
Education and training
Raising awareness /communications
Evaluation
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Community Involvement

• Older Peoples Partnership Board-leadership role
• 2 community development workers
• Virtual reference groups
• Lay researchers
• Community Chest budget supporting groups in the
  community

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Education

• Major investment 6600 places
• Training Coordinator with admin support

Dementia and person centred care Exercise
leaders Specialist Training
Falls awareness Medication Low vision Foot
care

• Over 1000 staff have attended sessions on falls,
  dementia and low vision.

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Accreditation
Home Care Agencies, Day Service Providers
,Community groups, Housing Providers and Care
Home Providers

• Will become recognised as organisations which
  deliver good practice in the area of falls
  prevention
• Newcastle College has contract- full time
  assessor 4 part time assessors
• 183 services in the process

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Physical Activity

• 50 new exercise leaders (EXTEND)
• Leisure centre staff trained and providing
  specialist fall services across the county
• Over 3000 older people accessing fishnets related
  physical activity

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Intermediate Care

• 6 new therapy posts
• falls pathway
• Cryer tool in place a as first line assessment
• Ambulance crews direct referral route to falls
  team
• Support other aspects of project notably exercise

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Small Task and Repair Service.

• Countywide coverage of handy person service from
  April 07
• Approx 1500 home safety checks

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Evaluation
Evaluation team includes Newcastle University and
Northumbria University
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Communications

• Web site with information and links about
  services to keep you fit, healthy, safe and
  involved
• (www.northumberlandfishnets.org)
• Approx 1200 older people have attended Young _at_
  Heart and falls fair events

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Some of our early successes.
Sweeping the board
Getting the message across
Extending their skills !!

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Falls Pathway
Emergency admission
3rd Level multifactor assessment Focused
medical assessment

• Health and Well being
• Extend classes
• Handy man
• Community activities
• Walking for health

1st level Assessment (Cryer Tool) North
Intermediate care team South Intermediate Care
Team Central Intermediate care
team West Intermediate Care Team Each team
will gather statistical data of fallers and sign
post to appropriate service as follows
H I gh Ri sk 3
2nd level assessment Community Rehabilitation
Team for , therapeutic intervention and/or
signposting Tinetti gait and balance assessment
Inform GP if unexplained fall and refer for
focused medical assessment

• Presents with fall
• Appears at risk of
• falls
• Attends routine
• elderly check
• Attends health and well being check
• Part of
• osteoporosis
• audit
• NEAS
• Social care
• services

• Recurrent fall
• Single injurious fall
• Single fall from abnormal
  gait/balance

Leisure Centre 12 week ProgrammePostural
stability.
Low Ri sk 0-2
Sign posting to Health and Wellbeing
October 2006
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Is it working?

• 12 reduction in hip fractures in 1st year
• Care homes reporting up to 30 reduction in falls
• NEAS reporting significant reduction in call outs
  for fallers
• Local evaluation of QOL identifying positive
  responses
• NE initial indications that POPPs sites are
  seeing an impact on hospital admissions and
  emergency bed days

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Added value

• Inclusion of falls into Skills for Care national
  induction knowledge sets from December 2007
• Building community capacity ( Lionhearts)
• Some larger national organisations wish to roll
  out elements of the accreditation programme
  across their broader economy.

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What weve learnt

• People want to be involved.
• It takes time to get things up and running
• Money isnt everything
• One thing leads to another
• Evidence is the key
• 2 years isnt enough

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Any questions?