Supporting better lives for frail older people

As the New Care Models Programme marks its first anniversary, the Commissioning Redesign Manager for Long Term Conditions at the NHS Solihull CCG, outlines the vital work its vanguard is doing:

The Solihull Together for Better Lives vanguard is committed to supporting people to stay independent and out of hospital.

As part of this commitment, local health and social care partners have implemented the integrated care and support in Solihull (ICASS) programme to improve care for frail, older people.

Falls prevention is an important element of the programme and this work truly does support better lives.

Our falls ‘pathway’ sees a wide range of partners working together for the benefit of local people, including our secondary and community health care providers, community housing, social care and voluntary organisations.

The pathway includes a 20-week postural stability programme run by Solihull Age UK for people aged 65 and over who have been referred after a fall.

While the programme is led by Age UK, they work in partnership with Solihull Hospital and the local community services including GPs. Participants are assessed before and after the programme and can be referred for further support and other community classes in the area if required, so that they can continue to improve their mobility.

The postural stability course is designed to increase their muscle tone and balance to help prevent future falls, and provide them with strategies to enable them to get up from the floor if they do fall.

More holistically, we’re also looking to reduce social isolation, depression and immobility. Many people are initially very fearful of having another fall, but their confidence builds over a couple of weeks on the programme.

Feedback has been very rewarding, with people saying things like: “I feel more confident and my family and friends have seen an improvement in my walking”; “The classes made me more conscious of what I can actually do”; “The exercise did me good and I intend to carry on” and “the sessions when we were shown how to recover from a fall were extremely helpful. In fact when I fell one night I could almost hear Shelagh’s instructions, so I was able to get up.”

What has surprised me the most is just how many falls we have locally and nationally and the tremendous difference these preventative services make in increasing people’s confidence.

I have very much enjoyed working with partners on developing this pathway, and we regularly review services to highlight areas for improvement, develop new ways of working and create a platform where new ideas can be shared.

Staff also feel energised and are suggesting innovative ways the services can be improved further. With an integrated pathway, it is important that services come together to generate this constant innovation and improvement as the pathway develops.

While it can be difficult when working across different organisations and agencies to ensure everyone knows how each service impacts and supports another across the pathway, becoming a vanguard has really supported our partnership working.


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  1. manjit kaur says:

    dear Bernadette you are very rewarding job its not easy work good luck for the future

  2. Jenny Roney says:

    Older people do need and value the support offered to them. I am currently involved in a pilot offering support to older people who have been discharged from hospital. We explain recent diagnosis and symptoms, medications, ways to keep healthy and safe, ensuring they know about future health care appointments, and signposting and referring on to others. The project has been so rewarding and feedback has been really positive people saying that the consultation has given them so much more understanding of there condition which in turn has given them the confidence and knowledge to carry on in their own homes. An assessment and consultation in peoples own home can provide so much more than a 10 minute appointment in a clinic or surgery.

  3. Karen Lewis - Therapy and Intermediate Care Lead Solihull Hospital says:

    Fear of falling or sustaining a fall can have a dramatic effect on peoples confidence and independence which can subsequently compromise social participation and wellbeing. I firmly agree with Bernadette that by working together across agencies we can create a “safety net” where those at risk can be identified, assessed and supported to decrease the likelihood or impact of falls. Education, self management and the opportunity for social engagement is as important as specialist intervention so it is vital that health, local Authority and the volountary sector work in partnership to meet the diverse needs of the people of solihull.