Falls (Older People)

• The consequences of falls are serious. Half of older people are unable to live independently following a hip fracture arising from a fall

• Around 40% of all admissions to care homes are as the result of a fall

• Prevention of falls is therefore key to enabling people to stay independent. Evidence suggests that targeting those at high-risk of falling and interventions which tackle a range of risk-factors (multi-factorial, not concentrating on just one risk factor alone) are the most successful

• Successful schemes/services/interventions should include as a minimum: home hazard identification/rectification/home aids/adaptations; evidence based exercise programmes; and medication review/appropriate identification and treatment of medical conditions

• Evidence shows that between 5 and 25 people need to be treated to prevent one fall. This favourable in comparison to many screening programmes

• The biggest risk factors for a fall are ever having fallen before and older age (those aged 80+). Local evidence suggests that this higher risk is apparent at younger ages (65+) in women in Wirral

• Wirral had a significantly higher rate of falls than England in 2014/15

• Seven out of every ten falls in Wirral are in those aged 65 and over; this has increased slightly on previous years

• Almost three-quarters (73%) of all injuries in older people attending Arrowe Park A&E were falls). The majority of these falls occur in the home environment

• The Wirral wards with the highest rate of hospital admissions due to falls were Claughton, Oxton, Prenton and New Brighton

• It is estimated that falls cost Wirral’s health and social care economy approximately £8.9million per annum, which equates to around £5,657 per fall

• There is a strong positive correlation between the number of patients taking 4 or more medications (poly-pharmacy) and number of falls admissions in Wirral

• In January 2017, over 40,000 people aged 65+ in Wirral were being regularly prescribed 4+ medications (poly-pharmacy patients). Females aged 80+ had the highest rate of polypharmacy

• Wirral has a higher rate of preventable sight loss than both the North West and England. Visual impairment is an important risk factor for falls

• Wirral has a higher prevalence of osteoporosis than both the North West and England. Osteoporosis can make the consequences of a fall more serious

Falls in Older People Section (May 2017)

Preventing falls and fall-related injuries in older people (Research)
This special collection produced by Cochrane Review focuses on the prevention of falls and fall-related injuries in older people, and they provide evidence of effective interventions. The collection includes reviews on the prevention of falls caused by visual impairment, prevention of falls in the community and falls in care settings, and the prevention of falls following major illness.

Frailty Evidence Review (August 2018)
There is a lack of consensus on a definition for frailty. This evidence review sets out to gather the latest and best known information to help understand the implications of frailty on a local population

Public Health Outcomes Framework
Falls indicators are generally in the 'Health Improvement' tab but this link covers all falls linked indicators

Falls: assessment and prevention of falls in older people NICE Clinical Guideline 161 (2013)
This guideline covers assessment of fall risk and interventions to prevent falls in people aged 65 and over. It aims to reduce the risk and incidence of falls and the associated distress, pain, injury, loss of confidence, loss of independence and mortality.