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Falls Service (Physiotherapy & Secondary Care Referral)

  

Anyone can have a fall, but older people are more vulnerable and likely to fall, especially if they have a long-term health condition.


Geriatrician Led Falls clinics are held at UHCW on a Monday and Tuesday afternoon & Rugby St. Cross on a Tuesday morning

Suitable patients for referral include those who have had falls or complex patients at high risk of falls who would benefit from Comprehensive Geriatric Assessment.

Whilst we would like to use clinic time more efficiently, we appreciate that our GP colleagues are pressured for time.

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.

  1. 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)
  2. 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
  3. It would be helpful if a lying and standing BP is checked

For younger independent adults with syncope, please consider referral to the T-LOC (transient loss of consciousness) clinic with our Cardiology Colleagues.

For contact details please see ‘Falls referral contact details’ in the useful links to the right.

Referral Criteria

The following patients are considered to be at high risk of falls and may be referred for further assessment:

  1. Single fall with gait and balance problem
  2. Recurrent falls in the last year
  3. Difficulties with walking or balance

Please see below for specific Coventry and Rugby information.

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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.   Geriatrician 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 physiotherapy service for functional assessment and exercise interventions.

During COVID patients are currently being seen in their home environment

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 Cardiology clinic for further assessment.

Rugby 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.   Geriatrician 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 Cardiology clinic for further assessment.

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