"The cost of Falls to the NHS is £1.7 billion each year."*

Structured, safe and effective exercise sessions have a positive outcome on a person's physiological and physiological life. Exercise programmes can reduce falls by up to 35 per cent in the high risk groups.

In 2009/10, people on Oldham's Falls Prevention exercise programme had a rate of falls of 15 per cent. According to the DTI statistics** "Each year in Britain 33 per cent of the population 65+ has a fall, and half of these (50 per cent) will have further falls." Therefore, half of the participants on the programme would be expected to have another fall, but just 15 per cent do. Falls and fear of falling are a major problem for the older person, and to society as a whole, causing a strain on finances and resources for the medical and care professions and leading to reduced mobility and independence and the increased risk of premature death for the faller.

Some common issues are that:

* Most falls that do not result in injury are never reported to health care professionals. * Falls are the leading cause of mortality due to injury, in older people aged 75 and over in the UK.

* 50 per cent of hip fracture patients lose the ability to live independently. * 14,000 older people a year die in the UK as a result of an osteoporosis hip fracture alone, with 33 per cent dying within a year of the fracture.

* The estimated cost to the NHS at 1.7 billion pounds a year, this figure is set to rise by 2 per cent a year: o 45 per cent of this figure is on acute care

o 50 per cent on social care, o 5 per cent on drugs and follow up.

* Based on current trends, hip fractures from falls in older people may rise to 120,000 per annum by 2015 ( DTI Research on pattern and trends in home accidents). Each hip fracture can cost up to £18,000. * 30 per cent of people aged over 65 years, fall at least once a year and the figure rises to 50 per cent of people aged 80 and over, according to DTI statistics. Older people who fall are 2-3 times more likely to fall again.

* About 40 per cent of admissions to care homes occur as a direct result of a fall. * Most falls happen in the home, with 75 per cent of falls related deaths happening in the home.

* Stairs or steps are a major problem with 57 per cent of reported falls.

The Psychological effects of falling, or fear of falling can be as damaging as the physical injury, leading to loss of confidence, social isolation, depression, increased dependence on others and loss of physical health and mobility for the individual concerned. In a study reported by Salkeld et al 2000, 80 per cent of women responded that they would rather die than lose independence and quality of life, that results from a bad hip fracture and subsequent admission to a nursing home.

Structured, safe and effective exercise sessions have a positive outcome on a person's physiological and physiological life. Exercise programmes can reduce falls by 15 per cent - 30 per cent in the high risk groups***.

If we were able to reduce fractures of the head or the femur by a conservative 15 per cent this could locally translate to 6 fewer people being admitted to residential or nursing and care home. The money saved for the support for older people could be 104 weeks at £350 per week, this works out at £218,400 pa****. A partnership between Age Concern Oldham and Oldham Community Leisure has been successfully running a Falls Prevention Programme in conjunction with and the Local Primary Care Trust for over six years now, providing eleven sessions a week for up to 15 clients per class. With five separate sessions lasting six months this gives us the capacity to take up to 150 clients through our Falls Prevention Programme per year.

Clients are referred via medical pathways, such as a GP, physiotherapist or falls prevention scheme at Oldham hospital.

Initially the sessions run for 6 months. Clients are initially assessed and tested for a base line result and are re-tested every 3 months, to monitor any improvements. The sessions last for approximately one hour, which includes discussion and advice, and approximately a 40 minute exercise session. The exercise session is initially chair based / seated and advances to standing and balance exercises with resistance exercises also included. The aim of the sessions is to provide support and motivation with a specialist exercise instructor, a chance for socializing and importantly, to improve posture, mobility, muscle and bone strength and balance and confidence.

The clients are provided with free transport and the sessions themselves are also free of charge.

After six months the clients progress onto the "Next steps" sessions. These are also run at Oldham Sports Centre and Tandle View court. These sessions are more advanced and build on the improvements in their muscular strength, balance, mobility and confidence that have been achieved in the first six months. To facilitate transition back into the mainstream the clients provide their own transport, usually ring and ride, or public transport but the sessions are still provided free of charge.

After this further six months of specialist exercise sessions it is hoped that the clients can access the mainstream exercise classes provided by Oldham Community Leisure, such as chair based exercise classes, line dancing, tai chi and other suitable activities.

Between April 2009 and end of March 2010, participants of the scheme were measures for the number of falls. Just 15 per cent of them had had a fall within this time period. According to the DTI statistics**: "Each year in Britain 33 per cent of the population 65+ has a fall, half of these at least twice".

This relates to a reduction of more than half the number of expected falls. The current annual cost of the Programme is just over the cost of one single hip fracture operation.

If just a little bit more money could be invested in Falls Prevention the money that could be saved in costs to the NHS, and the improvements to so many people's quality of life, would be immense.

* (Torgerson, D. J, Dolan P. The cost of Treating Osteoporotic Fractures in the United Kingdom Female Population (letter), Osteopros Int 2000; 11: 551- 52, as quoted in the National Services Framework for Older People 2001, Department of Health) ** http://www.dti.gov.uk/homesafetynetwork/fl-into.htm

*** BGS Guidelines, Cochrane Review Effectiveness Bulletin **** Bandolier- East Anglian Hip Fracture Study, Todd et all 1995