HelpFall vs ISTUMBLE – An Honest Comparison for ICBs

Why is a post-falls decision support tool needed? A lack of confidence among care staff to safely assess and respond to falls that occur in care homes and in the community is a major reason for high numbers of unnecessary ambulance call-outs to falls. 

Many ICBs are actively looking at how they can solve this problem, with most looking at implementing post falls decision-making tools and training to care homes and care organisations, to empower and upskill staff to respond to falls themselves. 

In this article, we will be comparing the two main post-fall decision support tools, HelpFall and ISTUMBLE, covering the positives and drawbacks of each tool to help you in your decision. 

What is ISTUMBLE?

The ISTUMBLE App is trademarked by Mangar, part of the Winncare Group. The ISTUMBLE app has been designed to perform a health assessment on a fallen person and check for injury, before lifting them on a Mangar lifting cushion.

ISTUMBLE is based on guidance from West Midlands Ambulance Service.  Originally available as a paper flowchart, it was written in the early 2010s and developed into an app in 2019.

Positives of ISTUMBLE

• Free of charge. ISTUMBLE is a free-of-charge app, available in app stores for anyone to download and use.
• Easy to use. ISTUMBLE has been designed to be intuitive and simple for carers to use, and by answering a few short questions they can decide whether to call 999 for an ambulance. It also includes videos on how to lift using the Mangar cushions at the end of the assessment. 
• Established. One of the first post-falls algorithms to be developed, ISTUMBLE has become well-known across NHS and social care settings.
• Customisable. ISTUMBLE can be customised with tailored clinical pathways to reflect the pathways in place in your area.
• Certified. ISTUMBLE is ORCHA certified.

Drawbacks of ISTUMBLE

• Only able to be used with Mangar cushions. Winncare state that the ISTUMBLE app is ‘only compatible with Mangar lifting cushions’, which restricts its use if your care homes use alternative equipment such as Raizer chairs. 
• Requires access to a phone or tablet. ISTUMBLE is an app, available for Android or iOS, so it can only be used if staff have access to a phone or a tablet with app store access.
• Lack of detailed guidance. The guidance can be ambiguous; you are either told to call 999 or lift the fallen person yourself and there is no middle-ground for minor-injury falls, leading to more 999 referrals than may be necessary. 

What is HelpFall?

HelpFall is the digital post-falls decision-making and reporting tool that supports care staff to safely assess a person who has fallen and helps them decide whether to lift them from the floor using safe manual handling techniques and equipment. 

HelpFall has been designed alongside ICBs and the NHS, and uses a traffic light system to categorise the fall and suggest what actions care staff should take based on their answers.  HelpFall is based on the South Western Ambulance NHS Foundation Trust Post Fall Assessment Checklist (🡥).

You can find out more about HelpFall here. 

Positives of HelpFall

• Prioritises reducing pressure on the NHS. One of the key problems ICBs identified with traditional tools was the risk-averse nature of the guidance. For example, if a person has fallen and suffered a minor cut to the arm, traditional tools would tell the responder to call 999. In reality, ‘minor injury’ falls can usually be treated within the care home or by an Urgent Community Response team, and we have built HelpFall to reflect this and to only revert to 999 for major injury falls. 
• Up-to-date guidance. HelpFall has been built to reflect the most up-to-date guidance from NICE and NHS England.  HelpFall’s traffic light system directly reflects the three tiers for falls, set out by NHS England in their ‘Going Further for Winter’ guidance – see here. More than just a checklist, HelpFall suggests actions the care staff should take in each situation. 
• Reporting. Every time HelpFall is used, an incident report is generated and sent to the care home or care organisation, to be uploaded to patient record systems and shared with the appropriate teams. ICBs can also receive quarterly insights reports (see example here), which give a clear and accurate analysis of the causes and outcomes of falls, enabling the ICB to put appropriate programmes and interventions in place. 
• Can be used in conjunction with any lifting equipment. Whilst we supply the Raizer lifting chair at Felgains, we have designed HelpFall to be able to be used regardless of the type of equipment you use to lift the fallen person off the floor. In fact, at the end of the assessment we have included instructional videos explaining how to lift a fallen person using either a Hoist, Mangar Cushion, Raizer Chair, or 2 dining chairs. 
• Customisable. HelpFall can be customised with tailored clinical pathways to reflect the pathways in place in your area.
• Certified. HelpFall is NHS DTAC-ready and ORCHA Certified. 

Drawbacks of HelpFall

• Cost. HelpFall is not a free-of-charge tool; we cover pricing in detail on this page. 
• Requires access to a web app. The HelpFall tool is hosted on the web and accessed via a QR code or weblink, so an electronic device with broadband or mobile signal will be needed to use HelpFall (a hard-copy checklist is available as a backup).  If a phone or tablet isn’t available, one of the care home’s PCs can be used. 

Which option should you choose?

What post-falls decision support tool your ICB actually chooses to implement will come down to a number of factors that will be unique to you, however, I hope this article has given you a better idea of what each tool does, and the positives and negatives of each. 

Often an ICB will choose to trial a tool before doing a system-wide implementation. As an example, Suffolk and North East Essex ICB recently completed a trial of HelpFall in a number of their care homes, and this video shows their initial feedback on the trial. 

Feel free to get in touch with us on 01473 741144, or by using the form at the bottom of this page to talk this through and get the process underway. 

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