The Falls and Syncope (a loss of consciousness for a short period) service at Gateshead Health NHS Foundation Trust has been operating for 21 years, providing a service to all residents in Gateshead (or those with a Gateshead GP) who have experienced an unexplained fall or collapse. The team primarily accepts referrals from GPs or other health professionals for those aged 14 and over.
Younger patient’s are referred to our service by their GP due to postural instability, dizziness or collapses. They are initially assessed in the clinic by one of the consultants, specialists and/or nurses. This assessment often involves a tilt table assessment, where we can look in a lot more detail at a person’s pulse and blood pressure when they go from a lying to a standing position, with the aim of reducing their symptoms but in a controlled environment. Th team work closely with services such as rheumatology, cardiology and paediatrics, amongst others, in our younger patient group.
The service consists of two consultant physicians, a specialist doctor in elderly care, two specialist nurses, a physiotherapist, and a clinical specialist occupational therapist. Two technical instructors and a secretary also support the team.
Karen Hunter, a Falls Specialist has worked at Gateshead Health for 40 years and within the Falls and Syncope service since its development 21 years ago.
Karen shares what a typical day looks like for the team:
A typical day starts with a strong cup of coffee, we then check for any referrals made by the Emergency Department and conduct telephone triage, which involves a phone call with the patient to better understand what care they need with these referrals to obtain a detailed fall history and then decide, with the patient, the best treatment plan. This could involve giving fall prevention advice, providing guidance, or arranging to see the patient at home or in the falls clinic for further assessment. Mornings are usually busy with home visits and specialist assessments in the patient’s environment, which continue into the afternoon, or conducting falls clinics at the Queen Elizabeth Hospital.
Our team is small but very busy, receiving over 100 referrals each month. Most of our referrals come from GPs, and we are part of Choose and Book, receiving referrals for patients outside our catchment area. These patients are usually seen in the clinic. All referrals are reviewed by our consultants and allocated to the area that can best meet the patient’s needs. This could mean seeing a consultant in the outpatient clinic, a nurse-led clinic, or at home by therapists and/or nurses.
The team meets every Thursday where we discuss patients who have been visited at home for advice regarding further interventions, or guidance for GPs to continue managing the patients’ fall risk in the community. Every day is different, as no two people fall the same way or for the same reason. That’s what makes my job so interesting – it certainly keeps you on your toes!
Karen Hunter, Falls Specialist