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Falls (Older People)

Falls (full chapter, May 2017)

Key Issues

  • 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

Key information sources for you to consider:

Frailty Evidence Review published August 2018

Public Health Outcomes Framework (Falls indicators are in the 'Health Improvement' tab)

Falls: assessment and prevention of falls in older people NICE Clinical Guideline 161 (2013)

Key information sources for you to consider:
Health and social care outcomes frameworks (Collection)
Public Health England Data and Knowledge Gateway
NHS Digital
Child and Maternal Health