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Falls


Introduction

Falls are the largest cause of emergency hospital admissions for older people, and significantly impact on long term outcomes, e.g. being a major precipitant of people moving from their own home to long term nursing or residential care[1].

Anyone can have a fall, but older people are more vulnerable and likely to fall, especially if they have a long-term health condition. Falls are a common, but often overlooked, cause of injury. Around 1 in 3 adults over 65 and half of people over 80 will have at least one fall a year. Most falls do not result in serious injury. But there's always a risk that a fall could lead to broken bones, and it can cause the person to lose confidence, become withdrawn, and feel as if they have lost their independence. In older people, falls can be particularly problematic because osteoporosis is a fairly common problem.
It can develop in both men and women, particularly in people who smoke, drink excessive amounts of alcohol, take steroid medicine, or have a family history of hip fractures. But older women are most at risk because osteoporosis is often associated with the hormonal changes that occur during the menopause [2].

Falls and fractures in those aged 65 and above account for over 4 million bed days per year in England alone, at an estimated cost of £2 billion [3].

The natural ageing process means that older people have an increased risk of having a fall.

Older people are more likely to have a fall because they may have:
  • balance problems and muscle weakness
  • vision loss
  • a long-term health condition, such as heart disease, dementia or low blood pressure (hypotension), which can lead to dizziness and a brief loss of consciousness [1].

Data Overview

For the year 2021/22, 735 falls were recorded for Oldham residents aged 65 and over. This equates to a rate of 2014 per 100,000, lower than both the North West (2,320) and England (2,100) rates. There is a similar pattern when broken down into smaller age bands, with a rate of 972 per 100,000 for 65-79 year olds, lower than the North West rate of 1,140 and the England rate of 993 and a rate of 5,035 per 100,000 for those aged 80 and over. This also falls below the North West rate of 5,744 and the England rate of 5,311 for the same age cohort.

For the 65+ cohort, Oldham ranks fairly averagely against benchmark areas, at 4th lowest in Greater Manchester and 9th lowest amongst CIPFA nearest neighbours.

Figure 1: Emergency admissions due to falls in people aged 65+ across Greater Manchester
Source: OHID, using HES and ONS data

Figure 2: Emergency admissions due to falls in people aged 65+ across CIPFA nearest neighbours
Source: OHID, using HES and ONS data

For the 65-79 cohort, Oldham ranks 2nd lowest across Greater Manchester and 7th lowest amongst CIPFA nearest neighbours.

Figure 3: Emergency admissions due to falls in people aged 65-79 across Greater Manchester
Source: OHID, using HES and ONS data

Figure 4: Emergency admissions due to falls in people aged 65-79 across CIPFA nearest neighbours
Source: OHID, using HES and ONS data

For the 80+ cohort, Oldham ranks 4th lowest across Greater Manchester and 9th lowest amongst CIPFA nearest neighbours.

Figure 5: Emergency admissions due to falls in people aged 80+ across Greater Manchester
Source: OHID, using HES and ONS data

Figure 6: Emergency admissions due to falls in people aged 80+ across CIPFA nearest neighbours
Source: OHID, using HES and ONS data

Further Information & Resources

NICE Quality standard [QS86] - Falls in Older People
This quality standard covers prevention of falls and assessment after a fall in older people (aged 65 and over) who are living in the community or staying in hospital. It describes high-quality care in priority areas for improvement.

Age UK Fall Prevention Advice
Age UK information and advice for older people to reduce and prevent falls.

NICE Clinical Guideline - Falls in older people: assessing risk and prevention
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.

References
[1] Department of Health (2012), improving outcomes and supporting transparency. Part2: Summary technical specifications of public health indicators. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_132358

[2] NHS Health A-Z, https://www.nhs.uk/conditions/falls/#:~:text=Older people are more likely,a brief loss of consciousness, accessed April 2024.

[3] Royal College of Physicians (2011), NHS services for falls and fractures in older people are inadequate, finds national clinical audit. Available at: https://www.rcplondon.ac.uk/news/nhs-services-falls-and-fractures-older-people-are-inadequate-finds-national-clinical-audit

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Contact


Health and Wellbeing Board

Oldham Council

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