Independent researchers have heralded an innovative NHS service in Glasgow which prevents elderly patients from falling and breaking their bones as the best in the UK.
And the service is also saving NHS Greater Glasgow and Clyde around half a million pounds a year which is being ploughed back into frontline services.
The researchers examined national repeat admissions for emergency hip surgery in elderly patients. They found that in Glasgow there has been a 3.6 per cent decrease in such operations between 1998 and 2008 compared to a rise of 5.1 per cent across Scotland as a whole and 16.2 per cent throughout England in the same period.
NHSGGC’s success is due to the creation of an innovative falls and fracture liaison service. The service includes specialist osteoporosis scanning and treatment clinics, specialist fall out-patient clinics, day hospital and community-based exercise classes and assessment of all fall risk factors in the home and residential institutions.
Thanks to this early intervention approach, since it was launched 10 years ago there has also been a 32 per cent reduction in hospital admissions due to falls in the home, a decrease of 32 per cent in residential homes and almost a 40 per cent drop in falls in the street.
Dr Liz Burleigh, Consultant Physician at the Victoria Infirmary’s Medicine for the Elderly Mansion House Unit, said:
“Everyone aged over 65 has access to this integrated service and we are seeing very positive results.
“When someone has a fall in their home for example occupational therapists visit to carry out a review of the patient’s home and suggest the removal of anything considered an obstacle, such as cabling or worn carpets which might cause a fall.
“Anyone who has had a fall is referred to hospital for a specialist medical review and nearly everyone is offered specialist physiotherapy exercise classes either at hospital or at a local community centre.
“Glasgow is streaks ahead of everyone else in developing this service and we are the first Board to actually show that this approach translates to reduce fracture incidence, and the feedback from patients has been very positive.”
Dr Alastair McLellan, Consultant Endocrinologist at the Western Infirmary added: “What we are providing is a holistic service.
“What makes us unique is that we pioneered not just the Fracture Liaison Service but also the integration of this service with the falls services. We address bone health (and treat when osteoporosis is found) through the Fracture Liaison Service but, we also address risks for breaking bones that arise from risk of falling, through the falls service.
“We thus identify the patients at highest risk of fracture, treat osteoporosis to reduce their risk of further fractures (when required) and refer them to the appropriate services to deal with their falls risk.”
“Equity of access for our patients is central to this service’s aims and there has been a big uptake of the service by patients.
Dr Dawn Skelton, Reader in Ageing and Health at Glasgow Caledonian University, and author of the evaluation report into the service, said:
“Unlike most falls services across the UK, the Glasgow service uses evidenced based methods to engage older people in interventions that maximise independent living and reduce the risk of further falls or fractures.
“The services consider all potential risk factors to bone health and falls, including health, medications, vision, continence, balance and strength.”
For more information contact either NHS Greater Glasgow and Clyde Communications on 0141 201 4429 or email [email protected]