Does NHS falls prevention stop first time falls?

Does the NHS falls prevention programme stop someone from falling or just try to stop them from falling again?

Our Lay Adviser Elaine Stott, Fitness instructor with a level 4 qualification in long term neurological conditions and Active4Life Community Development Officer, is involved in a new co-ordinated exercise service to support people coming through the falls prevention programme and those with long term conditions. Could this be a model for a co-ordinated approach to prevention and long-term exercise support?

We have a great Falls Prevention Team in the local area I work in, they are fantastic and do a great job, however, the participants referred to them, quite often, have already fallen again once they are referred from hospital. They may already have broken a hip, broken a leg, fractured a pelvis, the list goes on.

To help in NHS save funds, a preventative strategy could be more effective to help the people at risk of falling for the first time, to improve their balance and mobility so the fall doesn’t happen in the first place?

I work with this age group, with the people at risk of falling, at risk of doing themselves some real damage and we offer a session before they have a falling accident; functional exercises to improve balance, improve mobility, stability and generally make them stronger and more flexible, reducing the chance of falling accidents.

In my local area we also have amazing dedicated teams in place offering Falls Prevention, Pulmonary Rehabilitation, Neurological physiotherapy, Cardiac Rehabilitation, Exercise Referral Officers and Health Trainers. These teams do amazing, much needed work and help people living with long term conditions to get back on their feet and back into some form of physical activity. However, again, we hit a problem here, these teams have great groups and exercise/activity programmes but they usually last only 12 weeks. Unfortunately, most conditions are not cured within 12 weeks and the question is, where do the participants go then? Our Falls Prevention Team has a waiting list of 3 months, they have to be able to move people along, but where too? These people cannot cope with mainstream fitness classes, they are older, they have had a fall, they have replaced joints in hips and knees and they struggle still with mobility and balance, what do we do?

Pulmonary Rehabilitation also offer a great programme of 6 week blocks of exercise, but again they can’t keep people there longer, they have waiting lists. The people coming through this programme can still struggle with breathing, they need to rest between exercises and cannot keep up with a mainstream session in a gym. Where do they go?

People on the Exercise Referral Programme, who have been referred by a doctor, but don’t fit into the criteria for the sessions that are available, can’t be turned away, we need to offer an alternative, they have made a massive first step by coming to meet the Exercise Referral Officer, so what can we offer?

We need sustainable, community sessions for these people offering them a place to go and rehabilitate, that isn’t just 12 weeks, we need to offer a programme that runs every week for as long as they want to keep coming.

I work every day with this community, the focus of my work is targeted health, long term conditions and ensuring we have a session for everyone to feel comfortable with and for everyone’s ability. Our Local CCG has just put forward a grant of £10,000 to quadruple the work we are doing in this area. This is allowing us to set up an excellent Active4Life programme for the older and more vulnerable:

  • 8 weekly gentle exercise sessions, specifically for people with long term conditions
  • A weekly functional fitness session for participants with severe mobility issues who need extra help
  • 8 free Functional Fitness Courses to encourage people who have issues with mobility and help them see that the gym is not a scary place, that they can perform exercise and that we do have sessions suitable for them
  • Training for a wonderful group of older adult volunteers to help out in these weekly sessions!

All of the weekly sessions run at a £2.50 cost to each participant. The four we have set up are now completely self-sustaining, after just two months, each with 25 participants on a weekly basis! The results we have had are amazing, better balance, more mobility, less aches and pains, better mental wellbeing, more stability, weight loss, reduction in medication, and general better health!

Exercise is a hugely cost effective approach to tackling the long term conditions suffered by the older adults in our communities. A whole life approach to this could easily be put in place, we are looking at rolling out our ideas across the Greater Manchester boroughs. Having a specialist in Exercise Medicine based within the area to help oversee and coordinate these programmes would, I am sure, be hugely beneficial to the health of older adults in our communities. People are more willing these days to participate in activities if they think it is ok for them to do so, we work closely with the referral teams, we talk to the participants before they come down to our sessions, we let them come for the first time for free. If this coordinated approach was set up across the country, with Specialists in Exercise Medicine, Referral Officers, Physiotherapists, Rehabilitation Teams and Exercise Instructors all working together think of the outcomes, not just in savings to the NHS, but in the health and wellbeing of our nation!

Written by Elaine Stott Lay Adviser to the FSDEM (UK)