NHS Improvement has launched an investigation into the cost and prevalence of inpatient falls across the health service in a bid to better understand the problem and help trusts tackle it.
The regulator’s economics team is gathering data on the number of falls recorded in 2015-16 and will use the data to calculate the estimated cost of falls to the NHS, which could be as much as £15m a year.
Inpatient falls can lead to harm and even death, and vulnerable patients identified as being at risk of a fall often require one to one nursing – or “specialling” – which when unplanned means hospitals rely on costly agency staff.
Alongside the research, NHS Improvement will set up “falls collaboratives” and highlight examples of good practice that could be replicated across the NHS.
The work fits into efforts by the regulator to focus attention on the four most prevalent harms in hospitals – pressure ulcers, falls, urinary tract infections, and problems linked to blood clots or venous thromboembolism.
The regulator said that tackling these could release resources equivalent to 3,900 extra nurses being employed in the health service. Examples where trusts have made improvements include:
- University Hospitals Coventry and Warwickshire NHS Trust employed a permanent team trained to provide “specialling” for patients deemed at risk from falling. As a result use of agency staff fell 33% and saved the trust £162,000 over a year.
- East Lancashire Hospitals NHS Trust introduced ward based therapists as part of its nursing team to help patients with washing, dressing and using the toilet, and to assess the patient at the same time. The effect saw a reduction in falls and freed up nurses’ time.
- London Ambulance Service introduced a community nurse to work in emergency response to assess more patients at home. Seventy per cent more patients are treated at home with the number of hospital admissions reduced by 30 patients a week.
Ruth May, executive director of nursing at NHS Improvement and deputy chief nursing officer for England, said: “A key part of NHS Improvement’s mission is to help the NHS share good practice, and these examples of reducing patient falls and improving care are clearly helping frail and vulnerable patients.
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“Everybody knows that this is a critical year for the NHS,” she said. “As a service, we are throwing everything at the challenge we have been set and already starting to see signs of improvement, both clinically and financially.”
The research on patient falls will be published in coming months and used to develop new guidance on caring for vulnerable patients at risk of falls. NHS Improvement will also host an event on falls prevention later this month.