Up and About or Falling Short? - A Report of the Findings of a Mapping of Services for Falls Prevention in Older People

Section Two: About the Mapping

Questionnaire development

Questions were selected for the mapping which were considered specific to falls/fracture prevention and management. They related directly to national guidance and the current evidence base, and provided a good illustration of the local and national state of falls and osteoporosis services.

The questions were derived from:

• NHS Quality Improvement Scotland's Up and About. Pathways for the Prevention and Management of Falls and Fragility Fractures, 2010¹³
• The Scottish Executive's HDL (13) 2007: Delivery framework for adult rehabilitation. Prevention of falls in older adults.¹²
• The American Geriatrics Society and British Geriatrics Society's Clinical Practice Guideline: Prevention of Falls in Older Persons, 2009.¹⁵
• The British Orthopaedic Association's The Care of Patients with Fragility Fracture, 2007¹⁶
• The Department of Health's Prevention Package for Older People, 2009¹⁷
• The National Institute for Health and Clinical Excellence's Clinical Guideline 21 Falls: The assessment and prevention of falls in older people. 2004¹⁸

A number of questions were based on the Royal College of Physician's National Audit of the Organisation of Services for Falls and Bone Health of Older People¹⁹, carried out in England, Wales and Northern Ireland in 2008.

Completion of the mapping

The National Falls Programme Manager asked CH(C)P Falls Leads, in association with other colleagues with an understanding of the organisation of local services, to complete the mapping. In CH(C)Ps without a Lead, the CH(C)P's Head of Health and Community Care was asked to identify an appropriate person to take responsibility for the completion and return of the questionnaire. The exercise was, in effect, a self-assessment.

Thirteen of the fourteen territorial NHS boards completed the mapping in June 2011. In NHS Greater Glasgow and Clyde, the timing of the mapping coincided with a major re-organisation of rehabilitation services, and their request to postpone the exercise to September/October 2011 was agreed.

Questionnaire format

There were two parts to the questionnaire: Part One, which was multiple choice with some supplementary questions, and Part Two which was free text, and included questions relating to strategic leadership, information management, improvements to date, priorities for the next 12 months, barriers to change and the role of the National Falls Programme. Respondents were asked to complete both parts.

For a copy of the questionnaire, please contact the Falls Programme Manager at ann.murray3@nhs.net

Please find below an explanation of question/response table from Part One, including the key. Supplementary questions were included in some cases.

The three sectors of Glasgow CHP (North East, North West and South) provided individual responses. To simplify reporting, each sector will be referred to in the report as a CHP.

A previous mapping carried out in 2009/10 asked similar questions, but at an NHS board level. This revised questionnaire focuses specifically on service provision for older people living in CH(C)Ps/partnerships, because variation in practice within boards was difficult to capture using the previous format. Where possible, 2009/10 and 2011 findings are compared.

Individual CH(C)Ps and NHS boards are not referred to by name in the report. Each NHS board will receive a supplementary report which will enable them to identify their CH(C)P/s, and will identify variation within their board (where there is more than one CH(C)P). The supplementary report will also provide local information on rates of admissions with falls and hip fractures over the last ten years.