The consequences of a fall for an elderly person can often prove devastating, an event from which many of the most vulnerable never recover.
However, in our work supporting the families of those injured following falls in care, we see many hospitals continually failing to follow protocols which are in place to protect patients from harm.
Quite rightly, Shrewsbury and Telford Hospital NHS Trust has recently hit with a fine of £333,333 and ordered to repay £130,000 in costs following Health and Safety Executive (HSE) investigations into the deaths of five elderly patients at its hospitals following falls.
Four patients died as result of falling at the Princess Royal Hospital in Telford and a fifth succumbed to injuries at the Royal Shrewsbury Hospital. The patients, aged between 72 and 92, died between June 2011 and November 2012.
The HSE investigations found that fall prevention measures, including close supervision of the confused, were not properly applied. Poor consideration and communication surrounding measures to protect against falls arising from each patient’s particular frailties were also found.
Vince Joyce, Health and Safety Executive Principal Inspector for Shropshire, said the errors had been made despite ‘policies and procedures’ being in place at the Trust ‘to take reasonable precautions to prevent vulnerable patients from falling.’
Sadly, the failure to follow procedures – particularly with regard to protecting the elderly from falls – is something we see with great regularity on hospital wards across England and Wales.
Injuries – and deaths – are caused by simple oversights.
In one case handled by our medical negligence team earlier this year, South Tyneside NHS Foundation Trust admitted the poor care provided to an 83-year-old patient led to him suffering six falls in less than a month – one resulting in a broken hip which ultimately led to his death two weeks later, having developed urinary sepsis.
The cases in Shrewsbury and Telford has made many headlines due to the costly fine handed out, but the true cost of course has been the avoidable and sad loss of five lives.
Families need to be aware of measures hospitals should be taking to prevent elderly patients falling
When a vulnerable relative is admitted into hospital, it is important for families to be aware of the measures health professionals should be taking to prevent them from being injured in fall.
Under national care guidelines, any older people coming contact with any healthcare professionals should be asked whether they have fallen in the past year and the frequency, context and characteristics of the falls.
This information should then be used to devise a suitable care plan, aimed at reducing the risk of falls. However, we see many cases which such assessments don’t take place.
Simple steps such as ensuring all staff are aware of patients who are considered a ‘high risk’ of falling, and making sure sufficient staff are available to supervise, are often also overlooked.
Other simple measures, including the use of electronic sensor alarms which sound if a patient attempts to get out of bed unattended, or ensuring beds are in their lowest positions and have sides to prevent falling, are also often forgotten.
Families have right to ask questions over care and measures in place to reduce risk of falls
Our advice to families and relatives is that they are well within their rights to ask whether such measures have been put in place for their loved ones when they are admitted to hospital, and before they leave them in the care of others.
Should relatives feel such precautions have not been taken, they should be asking questions and demanding answers.
In the cases at Shrewsbury and Telford Hospital NHS Trust, one patient who should have been on enhanced supervision – a ‘bed watch’ – fell to the floor and sustained a bilateral subdural haematoma.
An 81 year old woman suffered three falls and a subdural bleed, a 92-year-old patient fractured her shoulder in a fall, a 91 year-old woman died on the same evening that she fell out of bed, and a 72-year-old man died four days after falling and fracturing his left hip in hospital.
All of these deaths could possibly have been avoidable with the correct care in place.
Sadly, it is too late to change the care provided in these cases, but hopefully this investigation and subsequent media coverage will lead to greater awareness of families and lead to more questioning the care their loved one receive if it is not as it should be.