In a world protected by intellectual property, copyright and trademarks you would be forgiven for thinking that sharing an idea is to give something up rather than start something good. Understandably our economies are driven by profit and the accumulation of wealth, and as such the legislation is there to protect the entrepreneurial spirit, the investment effort and risk undertaken. 

The drive within public services is somewhat different - it isn't profit that motivates, it is the effort to make things better for the 'citizen' or in the case of the NHS - the patient. 

It was this collective desire to share and improve services for the patient that brought together over 100 ambulance staff and critical friends on Monday 28th January at Mary Ward House in London, #ProjectA being the banner around which we gathered. 

How do we improve the ambulance service's response to people who fall was the question on all our minds?

Sharing an idea however small or developed can be liberating especially in the drive to improve for all. 

This concept was met by enthusiasm as all 10 English Ambulance Trusts and the three national services of Scotland, Northern Ireland and Wales came together with falls experts and critical friends. 

Undoubtedly the issue of falls response has been a consistent theme of #ProjectA right from the launch event in June 2018 when one of the initial 16 ideas focused around falls prevention. 

Often though you need somewhere to start from, a spark of an idea, a small seed of thought or in our case a 'potential' framework for falls response by the ambulance service.

Is there someone out there who has had a go at unravelling the spaghetti of services that often encompass a response to falls?

Just as importantly - will they share it with every ambulance service?

The answer to both of these questions was "yes" - step forward the Welsh Ambulance Service (WAST) and the multi-disciplinary team that attended on Monday, led by Claire Roche (Assistant Director of Quality, Governance & Safety). Claire and team explained their story in how they had worked over a length of time to understand the Welsh Ambulance's response to falls through developing a Falls Framework that encompassed five areas: Prevention, Community Resilience, Assessment (hear and treat), Response (see and treat) and Avoiding further harm.

Their story was a fascinating insight into the untangling and curation of their response and services into a workable framework that could be easily understood, whilst providing a means to consider improvements in the service by stakeholders (be they community services, commissioners, care homes or patients). 

The WAST presentation was delivered with humility and a desire to share experience - openness and honesty. The room was hungry with questions and a considered belief that Wales was on to something... could their idea be taken to a national level whilst accepting local circumstances of individual ambulance services?  

Patient Experience participant Carol Munt summed up the WAST team brilliantly, Carol said that “WAST should stand for What A Superb Team”.

The afternoon was spent critiquing and assessing the WAST framework, sharing ideas from other services and how we could potentially build into a national falls framework based on the principles of local determination and choice with regard to services. An incredible amount of work was undertaken from 'good ideas' to 'local actions' to 'high level principles' for using the WAST framework in a national setting. It will take a little time to distil all the information and bring it together into a falls framework from the day but from the feedback received we are confident that this can be achieved - and the #ProjectA team has a desire to make this real.

Anna Parry Head of Strategy & Programmes for Association of Ambulance Chief Executives spoke about the next steps for the Falls collaborative. She said:

“We're going to capture principles from today, improve the experience for people who experience falls. It’s about commitment not compliance. Helping you to make connections to make improvements and making incremental improvements. We want to create a document that builds on the WAST Framework for falls as it’s an amazing starting point. We are going to share experience and data to make improvements in falls locally and nationally falls".

In many respects the day was summed up nicely by David Morgan from North East Ambulance Service (Quality Improvement Lead), who in his closing address simply pulled some post it notes out of his pockets and told the room that he'd already scribbled and swapped phone numbers with a number of colleagues from across the UK on good ideas that he wanted to follow up on.

Helen Bevan Chief Transformation Officer for NHS Horizons closed the day with some final thoughts:

“We have so much power to change things, collectively we can do so much more than individually.”

The next steps include ensuring falls has the appropriate profile in trusts. We'll be using more virtual meetings to connect people together to keep the conversation and energy going. We will also meet up again in six months’ time to share best practice and find out how we have progressed on the learning from the Falls event.

Connections made and the potential to build a Falls Framework for the Ambulance Service made for a good day for #ProjectA participants and a good day for the ambulance service and their patients. Sharing and learning is good!

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