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A national drive to tackle one of the most common causes of death resulting from injury in over 75s could cut the problem by up to 30 per cent and save the NHS millions of pounds, says a new report by the NHS Confederation

Falls are one of the leading causes of mortality resulting from injury in people over 75 in the UK. One in three people over 65  and half of people over 80 will suffer a fall each year. Falls account for 10 to 25 per cent of ambulance call outs for the over-65s.

The psychological impact of falling can be devastating too and lower levels of confidence and independence in older people, along with increased isolation and depression, often slow down recovery.Half of those with hip fracture never regain their former level of function and one in five die within three months.

The report highlights that the Department of Health itself has estimated that a falls prevention strategy could reduce the number of falls by 15 to 30 per cent.

Government policies for the last 20 years have focused on prevention, health promotion and integration as the way to tackle falls.

However, studies have shown that these policies have not been entirely successful. Many patients still experience disjointed care as falls and fracture services are not integrated and not enough is done to stop people falling again.

The report make the case for investing in rehabilitation and prevention falls services that link up organisations across health and social care. It also provides examples of where the NHS, social care and community services are already working together to set up effective falls services.

The NHS Confederation Ambulance Service Network and Community Health Services forum is calling for a concerted drive from the national to the local level to tackle falls. Its report makes a number of recommendations for making falls services work.

Ambulance Service Network director Jo Webber said:

"Falls are not only physically debilitating but, particularly for older people, they really knock their confidence and can slow recovery.

"We have to take the opportunity of the NHS reforms to get organisations across health, social care and local authorities working together.

"Effective falls services that are already up and running across the country show that for little initial investment patients are getting better care, more falls are being prevented and money is being saved.

"Half the people in this country over 80 will suffer a fall this year. As our population gets older, we have to recognise that working together on falls is going to be even more of a priority.

"There are mechanisms available in the NHS reforms to make joint working possible but they will require leadership from the national to local level to really work."

Whole system collaboration:

  • Health and Well being boards need to ensure services and commissioning for falls are joined up.
  • Organisations across public health, the NHS, social care and local government should share data.
  • Organisations should use the NHS patient number to keep track of people who fall and assess the care they receive
  • Health and social care budgets should be shared or aligned to support joined-up falls services.


The NHS Commissioning Board and Public Health England will need to enable clinical commissioning groups to work together to deliver a range of integrated falls services across health and social care locally.

As part of local authorities' public health advice mandate, councils should provide falls prevention information and support services.

Falls should play a major part of the needs assessment undertaken by commissioners.

Mechanisms to deliver better care

Falls and fracture indicators should be part of the Adult Social Care Outcomes Framework and new ambulance performance measures.

NHS trust quality accounts should prioritise reducing the number of and harm from fallsCommissioning quality and innovation (CQUIN) targets should include an indicator for reducing falls and avoidable admissions that encourages organisations to work together.

Written by Scott Buckler
Thursday, 10 May 2012 8:08

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