What are we trying to do? 

The FLEXI study will evaluate the implementation of the scale-up of the Falls Management Exercise (FaME) programme in Greater Manchester, Devon and the Midlands to help spread its adoption more widely. The FaME programme is an evidence-based group-based, face-to-face, six-month exercise programme specifically aimed at improving the strength and balance of people aged 65 and over. 

 

Why is this important? 

Falling can cause injury, pain, loss of confidence and independence. This is undesirable for the individual and their families, and places significant demands on health and social care services.

 

Falls are not inevitable. By improving an individual’s strength and balance, alongside skills to help getting up from a fall (should this happen), the likelihood of a fall occurring or having damaging consequences, such as a long lie on the floor, can be minimised.

 

Research has shown that FaME results in fewer falls, improved confidence, and reduced fear-of-falling. Despite this, FaME is still not available everywhere across England or delivered according to the evidence.  More needs to be understood about how best to increase its availability and ensure high quality delivery.

 

How are we doing it? 

To improve our understanding of FaME implementation, we previously studied FaME’s set-up, delivery and quality in the East Midlands. We learnt a lot about how to get FaME set-up and running and demonstrated that the programmes worked outside of a research setting. Using learning from the East Midlands, we developed a guide for implementing FaME called the implementation toolkit. 

 

This NICE endorsed, evidence-based toolkit contains all the information needed to set up and run a FaME programme, from making the initial business case to promoting it to participants. We now want to use this toolkit to see if FaME can be made more available in two new, and very different, regions: Greater Manchester and Devon. We will also assess whether FaME works in these populations, particularly if adaptations are necessary due to COVID-19.

 

We aim to:

• Understand how best to increase the availability of FaME in two new areas and assess the role that the toolkit plays in this. Using the toolkit we will work with local experts to promote FaME to organisations that decide what health services should be funded locally.
• Study the delivery of FaME in the new areas and see if programmes work in these populations by measuring improvements in participating individuals.
• Test ways of maintaining the quality of FaME programmes over time. Working with Later Life Training, a national not-for-profit organisation with expertise in FaME, we will measure the quality of programmes and test what works to make them better.

We will use this information to improve the FaME implementation toolkit and develop plans to support national implementation of FaME.

 

Who are we working with? 

• This is a collaboration between NIHR Applied Research Collaborations (ARC) East Midlands who are leading the project, ARC Greater Manchester and ARC South West Peninsula. We will be working with 3-5 local research sites in Greater Manchester and Devon.
• Additionally in Greater Manchester (and Devon) there is a FaME Programme Support Offer via the National Fame Implementation Team (N-FIT)
• The National FaME Implementation Team is a group of experts with specific knowledge on training and delivery of FaME, falls prevention pathways and policy drivers for falls prevention. They intend to update and improve the FaME Implementation Toolkit and facilitate a Community of Practice for FaME instructors, providers and commissioners. 
• N-FIT includes members from Later Life Training (LLT) who are a national not-for-profit organisation and leading provider of training for the FaME programme with expertise in FaME delivery and quality improvement.
• For the next 18 months it will also include members of the FLEXI Research Team.

 

N-FIT offers: 

 

• Expert advice and mentorship on commissioning, set-up and delivery of the FaME programme.
• An online Community of Practice (CoP) to share successes/challenges to Commissioners, Providers, and Postural Stability Instructors (PSIs)
• Quality Improvement advice to support your PSIs and service
• Advise on the evaluation of your service including cost analysis and participant / service outcomes
• Help you get off to the best start for your new sessions 
• Updating and improving the FaME Implementation Toolkit for commissioning, business planning, target population, training and funding

 

More information

 

 

Programme Manager
Gill Rizzello
gill.rizzello@manchester.ac.uk