"This risk assessment toolkit supports the recommendations relating to preventing falls in the NICE guideline in Falls in Older People and the statement on multifactorial risk assessment in the NICE quality standard for Falls in Older People."
National Institute for Health and Care Excellence | January 2017
Identify patients at risk of falls and, potentially at risk of unplanned hospital admissions
Search criteria incorporate:
Prompt background alerts to systematically identify at risk patients
Developed by Walsall CCG in partnership with Keele University (SystmOne version developed in partnership with Ardens Healthcare Informatics Ltd)
Identify patients over the age of 65 who may benefit from a medication review, falls assessment and sign-posting to local falls prevention services
Simple, intuitive and focused – in tests the toolkit was estimated to identify approximately 300 at-risk patients in a CCG of 280,000 patients2
Available free to use and fully compatible with EMIS Web and SystmOne clinical system
Falls are the largest cause of emergency hospital admissions for older people, with a significant negative 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 3,4. The human cost of falling includes distress, pain, injury, loss of confidence, loss of independence and mortality1.
Falls are estimated to cost the NHS more than £2 billion per year1. Furthermore, research suggests that, on average, the cost of hospital, community and social care services for patients who fall are almost four times as much in the 12 months after admission as the costs of the admission itself. Over the 12 months that follow admission for falls, costs can be 70 percent higher than in the 12 months before the fall; the most dramatic increase being in community care costs (160 percent)5.
With the number of people aged 65 and over predicted to increase by 2 million by 2021, costs are set to rise further5.
However, many falls are preventable by removing hazards, addressing deterioration in muscle strength, balance and vision. In addition, a person’s level of risk may unwittingly be increased by the prescription of certain medications. NICE recommends that “older people on psychotropic medications should have their medication reviewed, with specialist input if appropriate, and discontinued if possible to reduce their risk of falling”1.
Public Health England’s consensus statement on Falls and fracture6 emphasises that “Effective, planned, evidence-based approaches to falls and fracture risk reduction are of key importance to the health and wellbeing of people living in our communities and those that care for them. The routine identification of those most vulnerable to falling will allow the targeting of interventions which confer the best chances of avoiding injury and its potentially catastrophic consequences.
The Falls Risk Assessment Toolkit provides a simple but effective means for the whole healthcare team to proactively implement a review process whereby vulnerable patients can be identified, receive appropriate care and thus reduce their risk of falling.
1. Falls: assessment and prevention of falls in older people. NICE Clinical Guideline 161. June 2013 2. Figures based on testing across a sample of local practices. 3. Improving outcomes and supporting transparency. Part2: Summary technical specifications of public health indicators. Department of Health 2012. 4. Hospital in patient care: almost 900 more admissions per day compared to previous year. Health & Social Care Information Centre. February 2015. (www.hscic.gov.uk/. Accessed November 2015) 5. Tian Y, Thompson J, Buck D and Sonola L. Exploring the System-wide Costs of Falls in Older People in Torbay. Kings Fund. August 2013. 6. Falls and fracture consensus statement. Supporting commissioning for prevention. Public Health England with the National Falls Prevention Coordination Group member organisations. January 2017.
Centre for Medicines Optimisation
The Hornbeam, Keele University, Keele, Staffordshire, ST5 5BG.
T 01782 479790 E firstname.lastname@example.org
Developed as part of a joint working initiative comprising Walsall CCG and Prescribing Decision Support Ltd at the Centre for Medicines Optimisation, Keele University.
Both parties reserve the right to update and change the Falls Risk Assessment Toolkit at any time in order to address changes in clinical guidance and best practice, improve functionality and reflect changing user and business needs. Both parties also reserve the right to withdraw the Falls Risk Assessment Toolkit if and when its content is out of date and no longer consistent with clinical guidance.
Special thanks to Bharat Patel, Barbara Yates and Jaz Dhillon.
SystmOne version developed by Ardens Healthcare Informatics Ltd in partnership with Prescribing Decision Support Ltd at the Centre for Medicines Optimisation, Keele University.
Supported by an unrestricted grant from Flynn Pharma Ltd in the UK.
© 2018 Keele University © 2018 PDS Ltd © 2018 Walsall CCG