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Vaughan Gething AM, Minister for Health and Social Services

I am pleased to provide members with an update regarding the Welsh Ambulance Services NHS Trust (WAST) Falls Assistant response pilot, following comments raised during Business Questions on 8 January 2019.

People who have fallen account for over 10% of emergency calls received by the Welsh Ambulance Service and in 2017/18, the Trust received over 62,000 calls relating to falls, of which 50% resulted in a journey to hospital.

The Welsh Ambulance Service has developed a Falls Framework and Falls Response Model to enable it to provide a holistic approach to falls, from prevention to minimising the risk of further harm caused by prolonged periods of time spent on the floor awaiting an ambulance.

The Falls Assistant response pilot became fully operational on 1st December 2018, supported by £140,000 of Welsh Government funding, and forms part of the Trust’s Falls Response Model.  The primary objective of the pilot was to enhance patient experience for people who have fallen, but who are uninjured or have minor injuries, ensuring they receive a timely response and to prevent the need for an avoidable hospital admission.

In total, six Falls Assistant units have been operating 12 hours per day, seven days per week across Cardiff and Vale, Cwm Taf Morgannwg, Hywel Dda, Aneurin Bevan and Swansea Bay health board areas as part of the pilot, in order to attend a variety of calls within the Amber and Green categories.

Between 1st October 2018 - 31st March 2019, Falls Assistants responded to 1776 calls relating to falls or other welfare-related calls, thereby freeing up ambulance resources to attend higher priority calls.  Of these, 65% of the patients did not need to attend hospital, following referral to other areas of health and social care or closure at scene following treatment. 

The average response time after allocation was 24 minutes and the Falls Assistants spent an average of one hour and 27 minutes at scene undertaking assessments, referrals, assisting the patient from the floor and making sure they have everything they need in place to safely remain at home.

Early feedback received from patients has been positive, with 95% reporting positively about timeliness and the service meeting their expectations.  At a meeting of the Emergency Ambulance Services Committee (EASC) on 27th March, it was agreed that the pilot will be extended for a further three months to allow time for an evaluation to be undertaken to inform consideration of future delivery of the service. 

Another scheme supported as part of funding made available for the winter period, has seen hundreds of inflatable lifting equipment products, built in Wales, being provided to care homes to support people who have fallen. This was aligned to delivery of a training package for care home staff to support their understanding of how to prevent falls and manage people who have fallen.

The scheme was intended to improve the experience for care home residents who have fallen and are not injured, by reducing unnecessary delays in response and enabling older and frail people to be resettled more quickly.  It was also expected to reduce unnecessary dispatch of ambulance resources to care homes, as well as reducing conveyances of patients to hospital, thereby reducing the risk of harm to older, frail people who can be at greater risk of admission and longer stays in hospital, which can cause harm.

We have also been supporting ‘Hospital to Home’ pilots delivered in collaboration with Care and Repair Cymru in ten areas across Wales over the winter.  These schemes saw designated caseworkers joining integrated ward rounds and supporting front door services by identifying patients who would benefit from home adaptations and implementing solutions rapidly.  The aim was to support reductions in delayed transfers of care as well as reducing admission and readmission rates by providing rapid response adaptations to people’s homes.

Each of these initiatives will form part of an evaluation of winter pilots, following which consideration will be given to future implementation.

You may also wish to be aware that each year there is a Falls Awareness week in order to raise Falls awareness across Wales.  Falls Awareness Week, is a call for action to reduce the risks of falling, led by a conversation, self-assessment and advice.

Once the evaluation of the work set out in this statement have been completed I will of course be happy to update Members and the public.

I hope this response provides Members with the assurances regarding the range of activity being undertaken to prevent falls and safely manage people who have fallen.

This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Assembly returns I would be happy to do so.