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ABSTRACT

The management and prevention of falls is a policy priority in the United Kingdom¹. Although not specified as a long term condition, models of provision for falls services share features with the long term conditions service model². These include integrated services across health and social care in hospitals and the community; identification of high-risk patients and their proactive management; and systematic patient-centred care.
The model of service delivery for people who have fallen is exemplified by the integrated care pathway which maps out the patient�s journey through different service settings and disciplinary spheres of practice. Underpinned by research evidence, it constitutes professionals� proposition of what should happen to a person who has fallen, and indicates the links between various disciplines, services and agencies in the provision of falls-specific care.
I report on a qualitative, collaborative study (with practitioners and a service user group) being carried out in south-east London focused on quality of care in the context of falls prevention services. Objective: to develop a patient-centred tool for professionals to assess the quality of their care. Methods: recruitment of a purposive sample of older people who have fallen from different sites and sources of care across the pathway (Accident and Emergency departments, falls clinics, community nursing and social care services); individual depth interviews with older people and carers to explore their experiences and expectations of care and how they perceive the quality of care; focus groups with health and social care practitioners to appraise the indicators of quality as defined by patients (and carers) and to consider how these could be incorporated into practice; analysis of each dataset to identify common themes, individual differences and divergence; final phase to develop a pilot quality of care tool for professionals working in falls prevention services.
This study is in progress and preliminary findings will be reported.

References:
1. National Service Framework for Older People (2001), Department of Health.
2. National Service Framework for Long Term Conditions (2005), Department of Health.

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