Care of the Elderly Led Falls Clinics
Geriatrician Led Falls clinics are held at UHCW on a Monday and Tuesday afternoon & Rugby St. Cross on a Tuesday & Friday afternoon
Suitable patients for referral include those who have had falls or complex frail patients at high risk of falls who would benefit from Comprehensive Geriatric Assessment.
In addition to the circumstances of the fall and associated symptoms, social history and level of function, past medical history and drug history usually provided in the referral letter, we would be grateful if the following could be done whilst the patient awaits a clinic appointment.
- FBC, U&E, LFTs, Bone profile, Vitamin D, TSH, glucose, B12 and folate (CK and ESR if on statin or if there is a suggestion of myalgia)
- 12 lead ECG if history suggestive of a cardiac cause for syncope/fall OR if a patient is on heart rate limiting drugs e.g. beta-blockers, calcium channel blockers OR if there is no clear cause for the fall
- It would be helpful if a lying and standing BP is checked
For younger independent adults with syncope, please consider referral to Cardiology.
Care of the Elderly Department
Dr Suresh G. Gurijala FRCP Consultant Geriatrician
Dr Alice C.L. Ong PhD FRCP (Lon) Consultant Geriatrician
Dr James Gaywood MRCP (Lon) (Geriatric Medicine) Consultant Geriatrician
Dr Jayodi Sirisena MRCP (Lon) Locum Consultant Geriatrician
Please see below for specific Coventry, Nuneaton & Rugby information.
Coventry Guidance 
Routes of Referral
There are multiple individual services catering for patients at risk of falls. You may need to refer to more than one service.
1. Care of the Elderly Led Falls Clinics at University Hospital or Rugby St Cross Hospital
If appropriate, all patients at high risk of falls should be referred to one of these clinics via Referral Support Service (RSS). Please see right link for further details of the clinics.
2. Physiotherapy
If appropriate all patients at high risk of falls should be referred to a community physiotherapy service for functional assessment and exercise interventions.
Coventry Falls Prevention Service: This is physiotherapy led falls prevention service for Coventry patients, including a seven weeks falls exercise programme.
Patients will participate in exercises that are individually prescribed to each patient, and aimed at improving strength, balance and reducing the risk of further falls.
They are supported in class by a physiotherapist and a therapy assistant.
Included in the programme are education sessions and patients are also referred onto other relevant services where appropriate.
They are also advised about self-management exercise groups, such as EXTEND and Fit as a Fiddle.
Compliance with an individually prescribed Home Exercise programme, based on the evidenced based OTAGO exercise programme, is encouraged to support improvement.
After the 7 weeks programme, patients are reviewed using outcome measures and scores are compared to those of the initial assessment.
Patients are reviewed after 6 months over the telephone and plans for future maintenance or review are considered.
Where a referral identifies a therapy need related to fall/risk of falls the referral would be triaged in the ISPA (Integrated Single Point of Access) and allocated appropriately into our therapy pathway to support assessment and intervention.
You will NOT be required to complete a specific referral form for this
You can continue to use the referral form that you are using for Community therapy referrals; or by calling into the ISPA; noting falls/risk of falls/balance concerns/mobility concerns etc, and our triaging therapists will contact the patient if feasible to find out more and allocate to support an allocation to the correct waiting list.
Please see right for:
- a description of the service and contact details
- Falls referral form (please be aware, guidance notes are on page 3 of the form)
- A patient information leaflet on the Coventry Falls Physiotherapy Service
3. Occupational Therapy
All patients living at home should be considered for referral to an occupational therapist for home hazard assessment and intervention.
4. Cardiology Clinic
Patients suffering from syncope without other major falls risk factors should be referred to the Cardiology clinic for further assessment.
Rugby & South Warwickshire Guidance
Routes of Referral
There are multiple individual services catering for patients at risk of falls. You may need to refer to more than one service.
1. Care of the Elderly Led Falls Clinics at University Hospital or Rugby St Cross Hospital
Gerontology Referral via the NHS eReferral Service, contact Nick Balcombe, Consultant, University Hospital, Coventry and Warwickshire or Hospital of St Cross.
2. Physiotherapy
There is no specific physiotherapy service for Rugby patients to prevent falls. You may consider a referral to Core Physiotherapy in Rugby.
3. Occupational Therapy
All patients living at home should be considered for referral to an occupational therapist for home hazard assessment and intervention.
4. Cardiology Clinic
Patients suffering from syncope without other major falls risk factors should be referred to the Cardiology clinic for further assessment.
North Warwickshire Guidance
George Eliot Hospital Care of the Elderly Led Falls Service (Dr A Thakkar)
Referral Criteria
Elderly patients who fall regularly
Referral for full assessment and evaluation including blood tests and use of tilt table test
Therapist led clinic for initial assessment of falling patients especially in association with poor mobility rather than syncope or near syncope
There is no physiotherapy support for this service
Please refer using a full GP referral letter and NOT an obsolete falls proforma
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