Frailty (health and wellbeing needs in South Tyneside)

NHS Provisions:

• Community Falls Service: A multi-disciplinary team of physiotherapists, occupational therapist and nurses, covering both Sunderland and South Tyneside, with outpatient falls clinics. This would include rehabilitation services, comprising, among others, vestibular assessment and outreach services to see patients in their own home as needed.
• Falls and Syncope Clinic: Care of the Elderly physicians at South Tyneside District Hospital provide outpatient clinics for medical assessment along with clinical resources for the Community Falls Service. This would be directed at those who are the highest risk of falls, namely people who are elderly, frail or suffering from conditions affecting their autonomic function, or cardiovascular systems, or have polypharmacy are at risk of falls.
• Integrated Community Teams: Multidisciplinary teams providing acute nursing and rehabilitation for community patients.
• South Tyneside District Hospital: Providing acute inpatient and outpatient care for elderly or long term chronic disease management based on specialty.
• General Practitioners: Providing the majority of Primary Care, detection for long-term chronic disease.

Local authority provision:

These include, for the management of frail patients:

• Telecare services: For vulnerable adults at home.
• Transport: Bus passes and taxi sharing services to allow older adults to stay active and connected socially, along with improving access to healthcare.
• Equipment: The STAR Centre and local authority are able to provide equipment to improve functionality of patients based on needs assessed by occupational therapists.
• House Clearances and Warm Up North: Providing removal of waste to improve function and maintaining a warm home in winter months, thereby reducing associated healthcare risks for the frail.
• Haven Court: A 'step down' facility providing care to adults, which can be referred into by both primary and secondary care.
• Sheltered Accommodation and Extended Care Facilities: Allowing for safe home environments, namely to the elderly population with variable levels of supervision or needs assistance.

Currently these services are not coordinated, and further integration and communication across health and social care will be required to optimise their use.

Charitable and third party contributions:

Tyne and Wear Care Alliance provide training to care homes on fall prevention. Age Concern South Tyneside provide gym and exercise classes to build strength and balance, classes to improve social engagement and handyman services to maintain people's homes.