Published: 2017-10-10T12:28:00Z

Training provided by the Specialist Skills team at North East Ambulance Service NHS Foundation Trust to some of the region’s care homes has resulted in a reduction in 999 calls and A&E admissions.

North East Ambulance Service (NEAS) worked in partnership with the region’s Clinical Commissioning Groups (CCGs) to deliver Falls and Initial Response Skills Training (FIRST) to improve residents’ care and to reduce pressure on health care services.

The falls response training aimed to empower nurses and staff by giving them the skills and confidence to deal with residents who have taken ill, or had a fall, to enable care to be provided more quickly and closer to the patient.

Falls-related injuries particularly affect the frail elderly, with 30% of people aged 65 and older and 50% of people aged 80 and older falling at least once a year. Falls are estimated to cost the NHS nationally more than £2.3 billion per year, which equates to around £115 million each year for the North East.  The human cost of falling is an impact on the quality of life, resulting in distress, pain, injury, loss of confidence or loss of independence and they can lead to mortality.

Elaine McDonald, head of workforce development at NEAS, said: “Giving care home staff the skills and confidence to deal with falls in the most appropriate way enables them to put the care of their patients first – which doesn’t always mean calling 999. Since the training took place there has also been a demonstrable reduction in 999 call volume, which appears to show direct correlation with those care homes which have attended the training, reducing overall pressure on healthcare services.          

“Overall, there is a benefit for our frail elderly, care home staff, front-line healthcare resources and secondary care organisations and we hope to continue this programme with other care homes across the region.”

Training was delivered by the Trust’s specialist skills team to 414 staff across 115 care homes across the region.  The training was funded as part of the 2016/17 Urgent and Emergency Care (UEC) Vanguard.

Early indications show the training is working. Data from February and March, compared to the same time last year, has shown a 32% reduction in calls to 999 from the care homes trained, together with a reduction in the number of A&E by 25%.

The training included:

  • guidance on moving patients

  • confidence to respond to patients who had suffered a fall

  • guidance on assessing of patient condition

  • scene and risk assessment guidance to determine the most appropriate response

Janice Grieve, care assistant at Princes Court, North Shields attended the training. She said: “I work with a lot of vulnerable and frail older people and falls can be a regular occurrence. This training gives you the confidence to handle cases before calling 999, and to try and assist and care for people who’ve had a fall within the care home, if it’s the safest option.”

Trish Playle, senior carer at Cobal House in Cullercoats, who also participated in the training, added: We have regular training but this course was a great refresher. More often than not, when an elderly person in a care home has a fall, the immediate reaction is to call 999. However, this may not always be the best option for the patient. It also puts an unnecessary strain on A&E departments and ambulance services.

“Elderly patients, particularly those with dementia, can get disorientated when they leave their familiar surroundings. So if the fall can be treated at the care home, and it’s in the best interest of the patient, we should encourage this to happen on a more regular basis.

“It’s all about giving the best care to our residents and also giving staff the confidence to deal with trips and falls themselves if appropriate.”

NEAS is now looking for opportunities and funding to extend the reach of the training, looking at different user groups and catchment areas.

For more information or to book one of the many training courses that the Specialist Skills team offer please contact jo.wood@neas.nhs.uk

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