Paramedic Active Lives Promotion for Older People (ParAde)

Funding:

NHS Bristol, North Somerset and South Gloucestershire ICB Research Capability Funding­­.

What is the problem?

The UK population is growing and getting older with 5.8 million people aged 75+ in 2020. Falls cost the NHS 2.3 billion pounds every year and are the most common cause of injury and admission to hospital for older people. Older people are at particular risk of harm from staying in hospital due to an associated reduction in the ability to perform normal daily living activities which can lead to a loss of independence. Preventing falls is therefore essential to prevent injuries and deaths, reduce the need to go to hospital and reduce the time spent in hospital which is important for older adults and is a priority of the NHS.

Physical activity improves health, reduces the risk of falling, helps people to keep their independence and has positive benefits for mental health as well as social and emotional wellbeing. Exercise also maintains muscle strength and increases bone density meaning that fractures are far less likely if a fall does happen. However, we know from the Chief Medical Officers 2023 annual report that only 6% of men and 4% of women meet the physical activity guidelines (even less in older people). The report also recommends a much greater research effort for older people from all professions.

Initial patient and public involvement (PPI) work found that patients find information like the ‘Get up and Go’ booklet very helpful and they liked being supported to be proactive about their falls risk rather than considering it an inevitable part of ageing. The booklet contains a few simple exercises that people can do at home to help reduce the risk of falls as well as information about other risk factors to be considered such as taking many medications or poor eyesight. However, we found that people didn’t know about these resources. This project will assess the potential for increasing the reach of these resources using the unique patient contacts of paramedics and will target several of the BNSSG priorities including supporting people to age well and supporting healthy behaviours.

What is the aim of the research?

This project will assess the feasibility of paramedics identifying older patients at risk of falling and ‘making every contact count’ by promoting existing information and/or initiatives available to patients about how they can reduce this risk.

This project aims to empower older people to engage in healthy behaviours which can reduce the risk of falls, therefore preventing injuries, reducing the number of patients needing to go to hospital, reducing the time patients spend in hospital (and the associated healthcare costs) and improving outcomes that are important to patients.

How will this be achieved?

In order to ensure co-production of a strong NIHR RfPB bid the following preparatory work is proposed:

1. Partner development and team building.

The project team will continue to be strengthened in order to secure the right expertise and create buy-in. This will boost the meaningful impact of the research and help to share knowledge and generate change of practice.

Existing external relationships with groups such as Age UK Gloucester and the Bristol Health Partners will be developed further in order to seek input and support for the research and explore pathways to impact.

2. PPI and stakeholder engagement

Initial PPI work with older people will be expanded to ensure a fully co-produced bid with a focus on including a diverse and inclusive range of experiences including under-served communities.

Paramedic engagement will be undertaken through links to the South Western Ambulance Service NHS Foundation Trust to assess paramedic confidence in providing support to older people and seek their views on the proposed research.

Stakeholder and PPI engagement will gather insights on the research question, the methods used and which outcome to measure. Members will be invited to join the advisory group for the NIHR project.

3. Rapid review of potential promotion information

A variety of possible information options and existing resources (e.g. the Public Health England ‘Get up and go’ booklet) will be identified for paramedics to promote to patients and will include relevant information gathered through collaborator and stakeholder engagement.

4. Stakeholder consensus workshop

The results of the rapid review will be shared with stakeholders and PPI members in order to determine the most appropriate source of information for paramedics to promote to older patients in the NIHR feasibility study.

5. Bid writing

A Tier 2 NIHR RfPB bid will be prepared and submitted for a feasibility study to assess the potential for paramedics to empower older patients to reduce their risk of falling through the promotion of healthy behaviours.

Who is leading the research?

This research is led by Dr Helen Nicholson, Senior Research Fellow, University of the West of England (UWE Bristol).

Further information

For more information or to get involved with this project, please email bnssg.research@nhs.net