Overview
The Falls and Fracture Prevention Service is a therapy-led service offering assessments for people that have fallen or are at high risk of falling.
We offer one-to-one assessments with a qualified therapist (Occupational Therapist or Physiotherapist) which take approximately 1.5 hours. The therapist will look at strength, balance and the potential causes of falls.
At the end of the assessment a care plan will be formulated depending upon your individual need. This may include:
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Falls prevention education and advice
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Tailored home exercise programme
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Postural stability exercise groups (*assessment required with therapist)
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Home hazard assessments
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Further investigation of unexplained falls
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Onward referrals or signposting to other services
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Recommendations to community exercise groups
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The current average waiting time for the Falls service is 3.6 weeks.
Calls may be recorded for training and quality purposes. To find out more, visit Personal information – Bromley Healthcare.
Who this service is for?
Patients aged 65 and over, who have fallen or who are at high risk of falling, can either self-refer or be referred to the service by a healthcare professional.
Self-referral: If you are aged 65 and over and you feel that you would benefit from receiving an assessment and intervention from the Falls and Fracture Prevention Service, please contact the UCR admin team at Bromley Healthcare by phoning 0300 330 5777 who will take the necessary details from you. If appropriate, the information will be passed on to a clinician who will contact you within 5 working days to discuss your referral in more detail. If it is felt you would be better seen by a different service, this will be discussed with you, and the referral passed on to the most appropriate service. This may result in your GP being advised to refer you onwards for further investigation.
If you would prefer to speak to your GP or healthcare professional: Please do so as they are also able to make a referral to the service.
Calls may be recorded for training and quality purposes. To find out more, visit Personal information – Bromley Healthcare.
Using this service
Please read all the criteria below before making a referral (including self-referral) to the service.
PLEASE NOTE: The Falls and Fracture Prevention Service is a community-based, therapy-led team providing assessment and interventions for those who have fallen/are at high risk of falling. The Falls and Fracture Prevention Service is a non-emergency service and does not provide a “pick-up service.”
Our team are able to accept your referral if you:
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- Are an adult aged 65 and over, Registered with a Bromley GP.
- Have a history of fall(s) within the last 12 months or are at high risk of falling due to balance problems or you have concerns about falling and have reduced your normal activity as a result.
- Are medically stable and without acute/recent injury.
If you are referring for the exercise group in addition to the above you must be:
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- Independently mobile with one or 2 walking sticks.
- Able to sit to stand from armless chair (you can use your arms to help) and walk to the back of a chair unaided.
- Able to exercise in standing (exercise classes last approximately an hour).
- Able to see and hear sufficiently to participate (wear your glasses and/or hearing aids as required).
- Able to follow and retain instructions.
- Willing and able to participate and attend consecutive sessions once a week for 12 weeks.
Our team are unable to accept referrals for people who:
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- Are under the age of 65yrs or not registered with a Bromley GP.
- Are medically unstable or have an acute/recent injury.
- Have un-investigated dizziness/fainting/loss of consciousness episodes. If you cannot recall the sensation of falling or landing or wake to find yourself on the floor please discuss this with your GP.
- Have had a recent injurious fall without a medical examination.
- Have been seen by the falls and Fracture Prevention team within the last 6 months and nothing has changed.
- Are already receiving physiotherapy/other acute rehabilitation needs (for example for a fracture/broken bone).
- Have severe cognitive impairment or learning disability that prevents them from following commands or participating in a rehabilitation programme.
- Fall due to alcohol or drug use.
- Have a newly diagnosed neurological condition.
If you are referring yourself to the exercise group in addition to the above, we cannot accept people who have:
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- Uncontrolled angina.
- Uncontrolled hypertension or arrhythmia.
- An acute orthopaedic or an acute medical condition.
Calls may be recorded for training and quality purposes. To find out more, visit Personal information – Bromley Healthcare.
Appointments
We offer therapy clinic appointments in locations across the borough (see the bottom of the page for clinic locations and times). For those that are housebound, we are able to arrange a home visit.
Additional ‘vestibular’ clinics are run on a required basis.
We will send you notification of your appointment in the post.
Cancelling an appointment: please give us as much notice as possible if you need to cancel your appointment, in order for us to be able to offer this appointment to somebody else.
Calls may be recorded for training and quality purposes. To find out more, visit Personal information – Bromley Healthcare.
Exercises
The videos in the link below have been created to help you with your exercises. You can watch them as many times as you like to help improve your technique. Your therapist will have selected exercises for you so please only do the exercises suggested for you.
Please ensure that before doing any of the exercises that you have watched the introduction and safety videos.
Calls may be recorded for training and quality purposes. To find out more, visit Personal information – Bromley Healthcare.
More information
nhs.uk
NHS Patient information – search for ‘Falls Prevention’. As well as having information regarding what to do to help reduce risk of falling, this website also has information regarding physical activity guidelines for older adults.
csp.uk
Chartered Society of Physiotherapists – search for ‘Falls Prevention’. The CSP gives information regarding reducing the risk of falls both in the home and when out and about. It also provides some basic safe exercises to start at home.
theros.org.uk
The Royal Osteoporosis Society gives information about osteoporosis and osteopenia and the management of these conditions including medications, diet and exercises.
Bromley and District Osteoporosis Support Group – Local organisations and advice services – London Borough of Bromley
Bromley and District Osteoporosis Support Group is a local group offering support and advice.
Age UK | The UK’s leading charity helping every older person who needs us
Age UK provide advice and information regarding what you can do to reduce your falls risk. Age UK also have information on: Ageing well. You can access local information via the national website.
Primetime | Mytime Active
Primetime from Mytime Active provide a number of exercise classes across the borough for the over 60s to suit your level of activity and ability. They are social and fun.
Wellbeing Cafés in Bromley borough. These provide the opportunity to meet other people for an educational and social event, with speakers from a variety of local healthcare providers and voluntary sectors that discuss their services. For more information go to:
You are invited to the Wellbeing Cafe (thecrayscollaborativepcn.co.uk)
Five Elms PCN – a network of 5 GP Surgeries covering Bromley Common, Biggin Hill & Farnborough
Other services that we sometimes link with or refer to that you may find useful:
Kent Association for the blind
If you you have been prescribed oral medication for osteoporosis, take a look at the Six Golden Rules video below from the Royal College of Physicians
Leaflets for patients:
Falls and Fracture Prevention Service
Independence and safety around the home
Reducing fear of falling: strategy planning
Calls may be recorded for training and quality purposes. To find out more, visit Personal information – Bromley Healthcare.
For professionals
For all potential referrals to the team:
Consider rehabilitation potential and ability to carry out and engage with an exercise programme.
Inclusion Criteria
High Risk of falls
If ‘Yes’ to 1 or more of the following:
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- Serious injury sustained, as a result of a fall, which required medical treatment (within previous 12 months) excluding fractures which require current rehabilitation e.g. hip, pelvis, upper limb, lower limb, spinal.
- Recurrent falls, (2 or more), within previous 12 months: excluding; falls that occur due to behaviour/life style choices/advanced dementia – that is, those falls risk factors which cannot be modified through physiotherapy/occupational therapy intervention – please discuss with the Falls team before referring.
- Inability to get up after a fall without assistance and do not have the means to call for help (at risk of a long lie).
- Frailty – patients with a Rockwood scale of 7 and above are unlikely to be suitable for specialist falls prevention intervention.
- Dizziness such as; vertigo – ‘a perception of movement of the environment, or self within the environment, disequilibrium – a feeling of unsteadiness or imbalance when standing, motion sickness – episodic dizziness symptoms induced by travel, other descriptions i.e. rocking, swaying, nausea, floating, swimming, double-vision, like being drunk, like being on a boat.
May not require referral to Specialist Falls Service
Low Risk of falls
No fall or single non-injurious fall with no gait or balance problems. As our primary goal is prevention: people with low risk of falls do not necessarily require specialist falls-prevention intervention.
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- Give the individual education advice regarding falls-prevention and exercise options for general health.
- Consider referral for Bromley Healthcare balance group exercises (Strong and StABLE exercise group) or other community based exercise groups if patient is interested.
Intermediate risk of falls
No fall(s) or single non-injurious fall but have gait and/or balance problems.
If gait and/or balance is impaired, consider as intermediate risk: Our goal is to improve risk factors. People with intermediate risk of falls do not necessarily require specialist falls prevention intervention.
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- Consider referral to Community Physiotherapy/Vita Health Physiotherapy, for tailored exercises to improve balance, gait and strength.
- Consider referral for Bromley Healthcare balance group exercises (Strong and StABLE exercise group) or other community based exercises if patient is interested.
Exclusion Criteria:
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- Suspected transient loss of consciousness:
- If 65 and over, GP to consider referral to Geriatrician Syncope clinic at the PRUH.
- If 64 and under, GP to consider referral to Cardiology Syncope Clinic at the PRUH. See NICE guidelines for further information.
- Patients who are unable to stand independently or those who use wheelchairs for indoor mobility or do not have the ability carry out exercises in standing safely.
- Falls that are a result of substance abuse or behaviour that cannot be altered by specialist falls prevention intervention.
- Patients who require moving and handling equipment for transfers.
- Patient has received intervention (including the exercise group) from the Falls and Fracture Prevention Service within the last 6 months and nothing has changed or altered altered with the patient’s symptoms/accomodation/lifestyle.
- Chronic dizziness which has been investigated and patient has had (vestibular) treatment and/or balance exercises in the recent past.
- Sudden onset of dizziness with no obvious cause that has not been investigated.
- Suspected transient loss of consciousness:
If you are a healthcare professional:
From 1 May 2024, patients (their carers/relatives) can self-refer to the service via the telephone. Please inform patients that they can do this if they are aged 65 and over. For safety, we are unable to accept self-referrals for those under the age of 65 years as their falls may be due to an undiagnosed medical condition.
If you as a health professional would like to refer a patient and the patient has agreed, either use the SPA form/ROP (for GPs) or the new 2024 referral form (all other health professionals).
Patients can be referred via the form for health care professionals on EMIS or by completing the following form:
Referral form for health and social care professionals (Non GP)
Balanced Lifestyle Group Referral Form
Calls may be recorded for training and quality purposes. To find out more, visit Personal information – Bromley Healthcare.