Older people, falls Older people, falls and neighbourhood working and neighbourhood working

TodayToday1. Falls in Bristol – the latest statistics1. Falls in Bristol – the latest statistics

andand NHS Bristol’s response ( NHS Bristol’s response (RobRob))

2.2. BreakBreak (at 12.15)(at 12.15)

3. Community awareness raising and 3. Community awareness raising and

Falls Awareness Day 2010 (Falls Awareness Day 2010 (Jo, Noshin, AlexJo, Noshin, Alex))

4.4. What’s new for 2011 – (What’s new for 2011 – (Rob, Louise, MichaelRob, Louise, Michael))

5.5. Working together – (Working together – (All of usAll of us))

Falls are the leading external cause Falls are the leading external cause of death for the over-75sof death for the over-75s

National falls factsNational falls facts

Every year between 33% and 50% of people over the age of 65 suffer a fall, (estimates from Help the Aged)

20% of fallers will need medical help and just under 10% will sustain a fracture

Fractured hips cost the NHS £1.8 billion every year: All smoking £5bn, (2009). All obesity £4.2bn, (2007).

Falls in BristolFalls in BristolEmergency admissions per day (over 65’s)Emergency admissions per day (over 65’s)

2007/08 2007/08 4.94.92008/09 2008/09 5.65.62009/10 2009/10 6.36.3(20010/11 (20010/11 est. 6.4)est. 6.4)

In 2009/10, 405 people over 65 were admitted to In 2009/10, 405 people over 65 were admitted to hospital with hip fracture, of which 15-30% die hospital with hip fracture, of which 15-30% die within 1 year, (60-121 deaths).within 1 year, (60-121 deaths).

Each year, falls cost NHS Bristol an estimated £28.5 million.

18,103 - 27,42918,103 - 27,429

Falls admissions in BristolFalls admissions in Bristol

Rates per 10,000 population of emergency admissions for fall-related injuries in 50+ and 65+ age groups

0

100

200

300

400

500

Rat

es p

er 1

0,00

0

50+ 180.0 204.9 229.4 166.4

65+ 328.5 371.5 416.2 304.9

2007/08 2008/09 2009/10 2010/11 YTD

Magda Szapeil, Avon IM&T consortium, 2011.

Projected Growth in RATEProjected Growth in RATEPROJECTION of Rates of emergency admissions for fall-related

injuries per 10,000 population in 50+ and 65+ age groups

100

200

300

400

500

600

700

2007

/08

2008

/09

2009

/10

2010

/11

2011

/12

2012

/13

2013

/14

2014

/15

2015

/16

2016

/17

2017

/18

2018

/19

2019

/20

2020

/21

2021

/22

2022

/23

2023

/24

2024

/25

2025

/26

2026

/27

Ra

tes

50+ 65+

Numbers projected to double in 15 years - 4,403 by 2025. 12 per day.

Falls clusters in Bristol

NHS Bristol’s responseNHS Bristol’s response

NHS Bristol strategyNHS Bristol strategy

Reduce costs of hip fractures by renegotiating tariff Reduce costs of hip fractures by renegotiating tariff and standards. Use savings to...and standards. Use savings to...

....invest in Fracture Liaison Service. “Treat the first, ....invest in Fracture Liaison Service. “Treat the first, prevent the second”. prevent the second”. Service design is underway.Service design is underway.

andand

Hip Fracture

Non hip fragility

fracture patients

Individuals at high risk of 1st fragilityfracture or other injurious falls

....develop Falls/Primary Prevention Services that identify people at high risk and respond effectively. Pilot before end 2011.

People currently at relatively low risk

Prevent frailty and preserve bone health through healthy lifestyles.

NHS Bristol Public Health falls / NHS Bristol Public Health falls / fracture priorities – 2011/12fracture priorities – 2011/12

1.1. Identify people who may be at risk – refer to GPIdentify people who may be at risk – refer to GP

2.2. Continue to raise awareness of how Continue to raise awareness of how improvements in diet, strength and balance, improvements in diet, strength and balance, footcare, eyesight, home environment and footcare, eyesight, home environment and medication management can reduce falls riskmedication management can reduce falls risk

3. 3. Help develop business case and design of Help develop business case and design of primary prevention services ready to pilot later primary prevention services ready to pilot later in 2011in 2011

““It appears that individualised exercise interventions with balance training at the

core of the programme are most effective for those at risk of falls, including those with

significant risk of fracture”.

(Gillespie et al. 2009)

Quoted from Department of Health, 2009.

Falls and fractures:Exercise Training to Prevent Falls

ContactsContacts

Rob BeningtonRob Benington

rob.benington@bristol.nhs.ukrob.benington@bristol.nhs.uk

Injury Prevention Manager, NHS BristolInjury Prevention Manager, NHS Bristol