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East Riding PCT – Alternative Falls Care Pathway Model

A model to develop new falls pathway for patients in East Riding, Yorkshire.


SIMUL8 Corporation and the NHS Institute for Innovation and Improvement have helped East Riding Primary Care Trust to win a Service Improvement award for simulating an alternative falls care pathway to test the business case for implementation.


The new pathway aimed to reduce the chances and numbers of people over 65 from falling, and to care for them in the community rather than taking them to A&E. East Riding PCT knew that 16.2% of A&E attendances were due to a fall, and that they could care for about 70% of these attendances without needing to go to A&E. The ageing population in East Riding was a major influence in prioritising this work. The pathway had a 3 tier approach from primary prevention, to a level 2 specific and specialist assessment and a level 3 specialist intervention to reduce risk of serious injury. A diversionary pathway was agreed with the Yorkshire Ambulance Service.

Whilst the principles of this new pathway were accepted, senior management needed to be convinced that the scheme was affordable. East Riding PCT decided to use simulation as a technique to test the potential impacts of the proposed change.

The Scenario Generator is a simulation tool developed by the NHS Institute for Innovation and Improvement and SIMUL8 Corporation. East Riding produced a simulation of the pathway using Scenario Generator and were able to demonstrate that as their population aged over the years to come, the new pathway would be the most effective and efficient way of delivering care


The results of the simulation persuaded the senior management team to adopt the pathway, and the Scenario Generator is now being utilised to seek greater insight on 8 new pathways to shift care into the community “ Using the Scenario Generator gave us a greater understanding and confidence to invest in the new pathway, “ said Jo Gaunt, Assistant Director Service Improvement at East Riding, “it helped us see the impact of a new pathway over time, the volumes of activity we were likely to need to plan for and how we could best deliver quality and value for money. I would say that we are less risk averse, but more confident about managing risk as a result”

Further Information

More information about Scenario Generator can be found at:


E.Riding PCT


SIMUL8 and NHS Institute

Contact Person

Claire Cordeaux

Contact Email

claire.c [at]


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