Falls: a community response | 3 key takeaways from the NHS ConfedExpo speech

At this year’s NHS Confed Expo, a particular speech caught our eye, titled ‘Falls: a community response‘. This session addressed the question: ‘How do systems come together to enable communities to better prevent and respond to those who have fallen at home?‘, and was sponsored by St John Ambulance Service. 

With falls being a topic we’re very passionate about here at Felgains, this speech really resonated with our views on falls and where the future of falls response should be heading. 

So, in this article, we’ll be covering 3 key takeaways that we took away from the speech, and digging into what they could mean for the future of falls. 

Image credits: St John Ambulance

1. Falls are a community health emergency and should be treated as such

When elderly people fall at home on their own and are left lying on the floor, that’s an emergency for them and an emergency for their families who may be unable to get to them quickly. We know all too well that elderly fallers left lying on the floor for a long period of time often come to serious harm, with falls being the leading cause of death in persons aged 65+¹. 

And yet, we’re not treating falls as a community health emergency. We’re not responding as a system and we’re not responding as communities in a way that we would as if someone had suffered an immediately life-threatening event such as a cardiac arrest. 

As a result of these failings, the outcomes of falls in the community are often negative – fallers are waiting on the floor for extended periods of time for a response, and they’re coming to further harm and having to be hospitalised as a result. 

This raises the question; what would falls outcomes look like if they were viewed as a community health emergency, and responded to in the same way as events like cardiac arrests? 

• Much faster response times: If falls were treated as an emergency, fallers would receive immediate attention and response. Caregivers, volunteers or communities would be alerted to the fall, and prompt assistance would be provided to the individual who fell. 
• Improved outcomes for fallers: This immediate response will undoubtedly help mitigate the severity of injuries, prevent secondary complications, and improve overall outcomes for fallers.
• Standardised processes: Just as cardiac arrest response follows standardized protocols like CPR, falls would have clear and established protocols for assessment, management, and care. These protocols would guide caregivers, volunteers, and local communities in assessing the fall, providing appropriate first aid, and responding to the fall in a safe and effective way.
• Public awareness and access to resources: Similar to public awareness campaigns for cardiac arrests, there would be increased public awareness about falls and their impact on health. Communities would be offered standardised falls response training in a similar way to CPR training, and communities could even be equipped with appropriate resources and lifting equipment to enable the general public to respond quickly and safely when a fall occurs. 
• Improved outcomes for the NHS and the whole healthcare system. Financially, falls are estimated to cost the NHS more than £2.3 billion every year, and the pressure falls put on staff, resources, and infrastructure is incalculable. If the burden of minor and non-injury falls was taken entirely off the NHS, the positive impact on the healthcare system would be massive. 

2. There is huge potential for the voluntary sector to influence falls outcomes in the community

Every day, hundreds of thousands of volunteers across the UK have a huge impact on outcomes in the community and throughout the NHS. 

We saw from the Covid pandemic just how big a part volunteering has in our healthcare system, with the NHS seeing over 750,000 volunteers stepping forward to assist in the delivery of the COVID-19 vaccination programme. 

A common perception is that volunteers are less professional or less trained than paid staff, but in reality, nothing could be further from the truth. Volunteers have a genuine desire to be active in their communities, helping the sick and vulnerable, and they are well-trained to enable them to help in the best way possible. 

In the case of falls, the voluntary sector is already doing a large amount in terms of falls prevention; working with groups of people who are at risk of falling, to improve their mobility, improve their confidence, and carry out home visits to remove falls hazards. 

If we could similarly equip the hundreds of thousands of volunteers with the skills, confidence, and tools to assess and respond to falls in the community, the impact could be truly phenomenal. 

3. A lack of education is leading to communities and care homes being reticent to respond to falls

There’s no doubt that when an elderly person falls, the immediate reaction of families and the local community is one of paralysis. There’s a common misperception that if someone has had a fall, they shouldn’t be moved or lifted due to the risk of causing further harm. 

In reality, for the majority of minor and non-injury falls, if the faller was to be assessed and lifted quickly in the community, the outcome for them would be significantly better than if they were to be left on the floor, waiting hours for an ambulance. 

The real problem here comes down to a lack of education and awareness around falls and the risks of responding immediately vs waiting for an ambulance response. If the general public was educated about falls in a similar way to events like cardiac arrests, the stigma attached to falls and the reticence to respond would decrease, and outcomes would certainly improve. 

This also applies to care homes. Care homes are one of the most common places for an elderly to have a fall, yet some care homes still have ‘no-lifting’ policies in place through the same fear of causing harm by moving the faller. Again, the issue comes down to a lack of education and awareness about assessing and responding to falls, as well as a lack of appropriate tools to give care home staff confidence in their decision-making and falls response. 

Citations

[1] https://www.cdc.gov/falls/data/fall-deaths.html

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