The Scalpel's Blog

10.08.18

The NICE impact on falls and fragility fractures

Falls should not be an inevitable part of ageing – and their snowball effect means the consequence of falls are far from limited to just hospital admissions, says Professor Gillian Leng, deputy chief executive and director of health and social care at NICE

Almost a third of over-65s in the UK have a fall at least once a year, with around 500,000 people presenting at hospital with fragility fractures. This is estimated to cost the NHS £4.4bn a year. As our population of older people continues to rise, it’s clear from these figures that reducing falls and effectively assessing fracture risk have never been more important.

The consequences of falls don’t stop at hospital admissions. Particularly for older people, one fall can generate further problems, such as a loss of independence and confidence, leading to physical and mental deterioration and frailty. People who fall are also more likely to suffer further falls and fractures. This snowball effect not only adds mounting pressure to our health and social care system, it threatens to deplete quality of life and fuel vulnerability. 

Over the years, NICE has produced a range of evidence-based guidance and resources to support healthcare professionals in this challenge. We have now published a new impact report, which highlights how our guidance has been implemented by the healthcare system and the progress made so far.

The report explores how NICE has helped to improve falls prevention, detecting and managing osteoporosis and fracture risk, support after fragility fracture, and the management of people who have experienced hip fracture – which alone is estimated to cost the NHS £2bn a year.

In 2013, NICE published guidance on falls in older people, and in 2015 we went on to issue a quality standard on this topic. Since their publication, monthly survey data revealed a reduction in the proportion of people experiencing a fall while in care and an increase in the recognition of the importance of frailty. The data also found that the proportion of trusts using fall risk prediction tools has reduced since NICE issued a recommendation that they should not be used in hospitals. These tools have not been shown to accurately predict the risk of falling. Instead, all patients over 65, and those aged 50 to 64 who may have a relevant underlying condition, should be considered as being at risk. They should be offered a multifactorial risk assessment taking account of things like any history of falls, medication they are on and visual impairment.

This is positive news and shows that we are moving in the right direction. Health and care professionals are basing their practice on evidence of what really works, and importantly, outcomes for people at risk of falling are improving as a result.

But there is still more work to be done.

For example, strength and balance training programmes have been shown to reduce the rate of falls. Our report found that although people are being referred to these programmes, uptake needs to improve. Also, while there is evidence that multifactorial risk assessments are being carried out in hospitals, the quality of content varies, which signals another area for improvement.

Falling should not become an inevitable part of ageing. At NICE we will continue to support professionals to make a positive impact on the prevention and management of fractures, falls and frailty. But, as a health and social care system, we must keep up the momentum and ensure those most at risk of falling remain at the very heart of evidence-based improvements.

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Lancashire County Council to pay £200k in legal costs after Virgin Care legal battle

17/08/2018Lancashire County Council to pay £200k in legal costs after Virgin Care legal battle

Lancashire County Council has agreed to pay £200,000 in legal costs to two NHS Trusts after their decision to hand a £104million cont... more >
Former inadequate West Midlands maternity unit upgraded by CQC

17/08/2018Former inadequate West Midlands maternity unit upgraded by CQC

Walsall Manor Hospital’s maternity services have been given an improved rating from the health inspectorate following assessments made in J... more >
Major hospital stalled by Carillion collapse will go ahead under government funding deal

16/08/2018Major hospital stalled by Carillion collapse will go ahead under government funding deal

The construction of a major Midlands hospital that had its future cast into doubt following the collapse of infrastructure giant Carillion has be... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now beyond doubt or dispute, other than in government, that the NHS is inadequately funded. Even the secretary of state has argued that it will need more mon... more > more last word articles >

the scalpel's daily blog

The NICE impact on falls and fragility fractures

10/08/2018The NICE impact on falls and fragility fractures

Falls should not be an inevitable part of ageing – and their snowball effect means the consequence of falls are far from limited to just hospital admissions, says Professor Gillian Leng, deputy chief executive and director of health and social care at NICE Almost a third of over-65s in the UK have a fall at least once a year, with a... more >
read more blog posts from 'the scalpel' >
332 304x150 NHE Callout banner.

comment

Listening to the frontline

15/08/2018Listening to the frontline

Professor Wendy Reid, executive director of education & quality and national medical director at Health Education England (HEE), shares insig... more >
Medication without harm

15/08/2018Medication without harm

The World Health Organization’s (WHO’s) Third Global Patient Safety Challenge, ‘Medication without harm,’ is ambitious, b... more >
Stepping up the fight against AMR

15/08/2018Stepping up the fight against AMR

Professor Mark Baker, director of the Centre for Guidelines at NICE, explains what the organisation is doing to support the fight against antimic... more >
Population health for the 21st century

15/08/2018Population health for the 21st century

NHS Partners Network (NHSPN) chief executive David Hare discusses the themes covered at his organisation’s Confed18 panel debate on populat... more >

health service focus

View all News

interviews

Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >
Scan4Safety: benefits across the whole supply chain

02/10/2017Scan4Safety: benefits across the whole supply chain

NHE interviews Gillian Fox, head of eProcurement (Scan4Safety) programme at NHS Supply Chain. How has the Scan4Safety initiative evolved sin... more >