Dr. Susan Coote:

The stark reality is that more than 50% of people with MS will experience a fall within a three-month period. The emotional consequences of falling, being afraid to leave the house, to go out or meet friends for coffee - that fear is the biggest thing. We developed an evidence-based programme which we would like to implement. We have been implementing it in MS Ireland through some of our specialist programmes and have seen great approaches. It is a nice example of where both occupational therapy and physiotherapy principles come together. It is not just about strength and balance, it is about that fear and helping people to plan their days so they are not fatigued and do not put themselves at risk of falling; it is very complicated. We have the evidence for its implementation. At MS Ireland, we have implemented these programmes through grants and fundraised income.

We are calling for statutory funding of our physiotherapy service. These are some of the programmes we deliver. There are fall prevention programmes in the enhanced community care older persons area but they do not suit people with MS. They have very different reasons for falling. You cannot have somebody who is 36 and has MS, who is a young mum of two kids going to school, sitting in the same programme as someone who is 85. It just does not work. We run many group programmes and have had a lot of success in online interventions. A positive side-effect of Covid is that we now have online specialist programmes. For example, today, my participants are working by themselves but next week I will sit down with a group of people with MS, stroke and Parkinson's who are experiencing falls and will work through a very evidence-based programme of education and exercise that will empower them to put in place the strategies they need to not fall and give them the confidence to go out and do the things they do. There have been real positive outcomes. For example, one lady had stopped going to mass because she was so afraid of falling and was then able to walk to mass by herself because her balance had improved but also her confidence. This is the real impact our programmes can make.

We mentioned the cost savings to the State earlier, which is a matter we must talk about. There are both benefits to the person and cost savings to the State, which outweigh the costs of implementing our programme. The key is that our programme is an adjunct to the community neurorehabilitation teams; people are seen in acute care, discharged to community neurorehabilitation teams and then charities provide ongoing support and care to make sure the beneficial gains in community neurorehabilitation teams are maintained and that people do not just stop and go home and then there is another void. It is about ensuring that we are filling that. The charities are best-placed to do that because we are the link between the healthcare system and the community and living well at home, engaging in the community and ensuring people live the lives of their choosing.