In 2011 in Scotland, approximately 8% of older people who fell received multifactorial assessment (MFA) and intervention delivered by NHS services. Our aim is to reach 20% by implementing the Falls Framework for Action for Scotland. Tests of opportunistic screening have demonstrated low uptake of MFA; many people don't want - or need - formal intervention from NHS services. A growing number of people over 60 use the internet (59%) with Scotland increasingly investing in technology solutions to improve health and well being. NHS 24's Smartcare Programme, provided the opportunity to explore the use technology to support self-management of falls risk. Our aim was to develop an online self management tool to enable users to assess falls risk and create a personalised falls prevention plan.
The concept of an online self management tool emerged from consultation with older people. A development group, comprising older people, the project lead and industry partners, coproduced the Falls Assistant. Content was aligned with NHS inform's Falls Information Zone content, to ensure consistent information. Specialist practitioners contributed to a validation process, which checked information generated by the tool was relevant and safe.
The tool sits on Scotland's Living-it-Up platform. Trigger questions identify people at high risk of falling, signposting them to health services. The tool enables users to consider risk factors and actions to reduce risk, and create a personalised plan. An 'exercise centre' includes strength and balance tests, a short film on exercise and 'taster' exercise programmes. Falls prevention-related games have also been created. Over 600 Falls Assistant sessions are currently recorded monthly. Focus groups and one to one interviews have been used to evaluate the Smartcare tools, including the Falls Assistant. Findings suggest the tool helps users self manage their falls risk and general health, and in some cases, impacts positively on anxiety about falling, and motivation and ability to perform daily activities.
The use of an internet tool potentially allows health and social care professionals to reach members of the public that are not currently engaging with traditional services either through choice or need. Additionally, as the use of the internet and digital technologies becomes more prevalent in everyone´s daily life it is essential that statutory services embrace this and look at how they can develop to meet these changing needs and demands.
Top three learning points
1 The importance of co production with service users and involving them in every step of the development
2 I learnt about iterative software design and how things are continually tested and changed to ensure the finished tool is fit for purpose
3 I learnt about working with other industries and sectors to produce a tool for the NHS
The project was funded by NHS24/Scottish Centre for telehealth and telecare through the Smartcare European Project.
This work was presented at Physiotherapy UK 2017.
For further information about this work, contact: Laura.Halcrow@ggc.scot.nhs.uk