Falls (health and wellbeing needs in South Tyneside)

Falls and fall-related injuries are a common and serious problem for older people. According to the latest Cochrane Review on falls, "About a third of community-dwelling people over 65 years old fall each year, and the rate of all related injuries increases with age". ^[14]

Falls can have serious consequences, e.g., fractures and head injuries ^[15]. Around 10% of falls result in a fracture ^[16] [17]; fall-associated fractures in older people are a significant source of morbidity and mortality ^[18].

About 15% of falls result from an external event that would cause most people to fall, a similar proportion have a single identifiable cause such as syncope, and the remainder result from multiple interacting factors ^[19].

Since many risk factors appear to interact in those who suffer fall related fractures ^[20], it is not clear to what extent interventions designed to prevent falls will also prevent hip or other fall-associated fractures.

Falls can also have psychological consequences: fear of falling and loss of confidence that can result in self restricted activity levels leading to a reduction in physical function and social interactions ^[21]. Falling puts a strain on the family and is an independent predictor of admission to a nursing home ^[22]."

The Public Health Outcomes Framework ^[23] reported that in 2019 / 20 there were around 234,793 emergency hospital admissions related to falls among patients aged 65 and over in England (a rate of 2,222 per 100,000 population), with around 157,366 (67%) of these patients aged 80 and over (a rate of 5,644 per 100,000).

For South Tyneside in 2019 / 20, this equated to 680 emergency hospital admissions among patients aged 65 and over (a rate of 2,242 per 100,000 and statistically similar to the England rate), with 420 emergency admissions in patients aged 80 and over (61.8%) with the rate of 5,252 per 100,000 also significantly similar to the rest of England.

It is also worth noting that despite statistically similar rates of emergency admissions for falls to the rest of England for over 65s and over 80s, South Tyneside has a significantly worse rate than England for emergency admissions for falls in patients aged 65 - 79 (at 1,204 per 100,000 population compared to a rate of 1,042 for England).

Falls were the ninth highest cause of disability adjusted life years (DALYs) in the UK in 2019 and the highest cause of injury. ^[24]

Short and long-term outlooks for patients are generally poor following a hip fracture, with an increased risk of dying in the following 12 months of between 18% and 33% and negative effects on daily living activities such as shopping and walking. A review of long-term disability found that around 20% of hip fracture patients entered long-term care in the first year after fracture.

In terms of annual activity and cost ^[3]:

• the Public Health Outcomes Framework (PHOF) ^[23] reported that in 2017 to 2018 there were around 220,160 emergency hospital admissions related to falls among patients aged 65 and over, with around 146,665 (66.6%) of these patients aged 80 and over
• falls were the ninth highest cause of disability-adjusted life years (DALYs) in England in 2013 and the leading cause of injury
• unaddressed fall hazards in the home are estimated to cost the NHS in England £435 million
• the total annual cost of fragility fractures to the UK has been estimated at £4.4 billion which includes £1.1 billion for social care; hip fractures account for around £2 billion of this sum.