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Moves to cut falls 'not working' Moves to cut falls 'not working'
(about 4 hours later)
There is little evidence that fall prevention programmes used throughout the NHS work, research suggests.There is little evidence that fall prevention programmes used throughout the NHS work, research suggests.
Falls are a major cause of injury among older people with one in three aged over 65 suffering a fall once a year.Falls are a major cause of injury among older people with one in three aged over 65 suffering a fall once a year.
However, a review of 19 trials involving 6,397 participants found little evidence that the schemes cut falls, or fall-related injuries.However, a review of 19 trials involving 6,397 participants found little evidence that the schemes cut falls, or fall-related injuries.
The study, by the Universities of Warwick and Oxford, is published online by the British Medical Journal.The study, by the Universities of Warwick and Oxford, is published online by the British Medical Journal.
Older people are not some peripheral, minority group, they are the main users of the NHS, and yet the way things are organised at the moment it seems to prioritise young people Dr David OliverBritish Geriatrics SocietyOlder people are not some peripheral, minority group, they are the main users of the NHS, and yet the way things are organised at the moment it seems to prioritise young people Dr David OliverBritish Geriatrics Society
It follows an audit by the Royal College of Physicians which was critical of the care given to elderly people who fall and fracture bones.It follows an audit by the Royal College of Physicians which was critical of the care given to elderly people who fall and fracture bones.
Both the government's National Service Framework for Older People in 2001 and the National Institute for Heath and Clinical Excellence (NICE) in 2004 have recommended fall prevention programmes.Both the government's National Service Framework for Older People in 2001 and the National Institute for Heath and Clinical Excellence (NICE) in 2004 have recommended fall prevention programmes.
These can include advice on issues such as how to improve strength and mobility, and on how to minimise risk around the home.These can include advice on issues such as how to improve strength and mobility, and on how to minimise risk around the home.
But the researchers say they have proved to be very variable, both in terms of the way patients are assessed, and the type of help offered.But the researchers say they have proved to be very variable, both in terms of the way patients are assessed, and the type of help offered.
They argue that the existing evidence is not conclusive and is not of the highest quality, and there is a pressing need for comprehensive evaluation of existing schemes to determine whether or not they work.They argue that the existing evidence is not conclusive and is not of the highest quality, and there is a pressing need for comprehensive evaluation of existing schemes to determine whether or not they work.
Falls are becoming an increasing problem for the NHS as the population ages. One in three people aged over 65 and, one in two aged over 80 suffer a fall at least once a year.Falls are becoming an increasing problem for the NHS as the population ages. One in three people aged over 65 and, one in two aged over 80 suffer a fall at least once a year.
Not only do they cause broken bones, and head injuries, they can leave people long-term disabled, fearful and dependent on others.Not only do they cause broken bones, and head injuries, they can leave people long-term disabled, fearful and dependent on others.
GP roleGP role
Dr David Oliver, honorary secretary of the British Geriatrics Society, said that the hospital sector would be overwhelmed if it was to give a comprehensive assessment and advice to every patient who was at risk of a fall.Dr David Oliver, honorary secretary of the British Geriatrics Society, said that the hospital sector would be overwhelmed if it was to give a comprehensive assessment and advice to every patient who was at risk of a fall.
The only way to deal effectively with the problem was to make more funds available, and to encourage GPs to deal with the problem more proactively in a primary care setting.The only way to deal effectively with the problem was to make more funds available, and to encourage GPs to deal with the problem more proactively in a primary care setting.
"A lot of localities have fall and osteoporosis clinics, but they can't see most of the people who need to be seen," he said."A lot of localities have fall and osteoporosis clinics, but they can't see most of the people who need to be seen," he said.
"And if you do get seen it is not good enough simply to go through a superficial box-ticking exercise."And if you do get seen it is not good enough simply to go through a superficial box-ticking exercise.
"Older people are not some peripheral, minority group, they are the main users of the NHS, and yet the way things are organised at the moment it seems to prioritise young people.""Older people are not some peripheral, minority group, they are the main users of the NHS, and yet the way things are organised at the moment it seems to prioritise young people."
Dr Oliver said treatment for people who have suffered falls and fractures works and can reduce further falls or fractures by 30-40%.Dr Oliver said treatment for people who have suffered falls and fractures works and can reduce further falls or fractures by 30-40%.
Impetus for change
Pamela Holmes, of the charity Help the Aged, said: "Having a fall is such a disastrous event for an older person that we must, as a society, do all we can to prevent falling. "People die as a result of a fall, or break a hip and end up in long term care.
"This latest analysis shows that what is being provided at the moment is, in many places, simply not good enough."
We need to use this research to drive up standards, to spur on those working in falls services to provide specific, targeted and high quality care so that in future we see a sustained reduction in the number of people who fall and are injured."
A Department of Health spokesperson said a new strategy on dealing with falls was currently being developed.A Department of Health spokesperson said a new strategy on dealing with falls was currently being developed.
"This will include a review of the evidence on falls interventions and streamlining to specialist and intermediate care.""This will include a review of the evidence on falls interventions and streamlining to specialist and intermediate care."