Why is it important?
One-in-three adults aged over 65 in Salford will experience a fall at least once a year. Falls can be life-changing, costing people their health and independence. Falls are among the leading causes of emergency hospital admissions for older people, and have significant impact on health and wellbeing outcomes including:
- Serious injuries (including hip fracture)
- Disability
- Reliance on long term nursing or residential care
- Mortality
They are among the top 10 underlying causes of deaths in people aged 65+ and the leading underlying cause of death resulting from injuries in people aged 65+ in the UK.
Also, according to NICE, it is estimated that about 30% of people (2.5 million) aged 65+ living at home and about 50% of people aged 80+ living at home or in residential care will experience an episode of fall at least once a year. In 2022/23 there were around 220,000 emergency hospital admissions in England related to falls among patients aged 65 and over, with 142,000 (65%) of these patients aged 80+ and 35% aged 65-79 years.
The Office for Health Improvement and Disparities (OHID) guidance Falls: applying All Our Health reports that 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.
What is the current position in Salford?
The rate of emergency hospital admissions due to accidental falls in people aged 65+ in Salford has been worse than the England level for more than a decade (from 2010/11 to 2023/24): The latest published figures (2023/24) show that 2,663 Salford residents per 100,000 aged 65+ were admitted to hospital due to accidental fall. This is 34% higher than the England rate (1,984 per 100,000), 28% higher than the North West regional rate (2,088 per 100,000) and 18% higher than the Greater Manchester rate (2,248 per 100,000).
Salford has seen an improvement in the rate of falls over the last decade, but the local rate remains significantly higher than the national rate.
[Download the emergency hospital admissions data, csv format, 2kb]
The chart above shows that there has been on average some improvements in the admission rate, particularly since 2015/16, when the gaps to England and Greater Manchester have been gradually closing. However, rates remain significantly higher than both comparators.
Who are the individuals the most affected in the older population?
Locally, residents aged over 80 years old are around five times more likely to have a fall-related hospital admission than those aged 65 to 79 years old. This ratio is higher than that seen nationally or regionally, where the older group are around three times more likely to have a fall and a consequent hospital admission. Females in Salford have an 11% higher admission rate than males and nationally there is a significantly higher rate for older people living in deprived areas.
A related indicator measures emergency admissions for hip fractures in the over-65 population, for the five-year period ending in 2020/21. Five of Salford’s wards have admission rates significantly higher than England, with the highest, Broughton, almost double the national average but this could be impacted by accommodation tailored to older people in the area, including care homes. The other higher wards are Ordsall, Eccles, Little Hulton and Claremont. None of Salford’s wards are significantly lower than England. Quays ward has insufficient numbers to calculate a reliable rate.
Salford wards have a wide range of levels of hospital admissions for hip fractures, with the highest rate in Broughton ward.
[Download the emergency hospital admissions map data, csv format, 1kb]
What can be done?
- Primary Prevention focuses on reducing risk factors and encouraging behaviour changes through lifestyle improvements, such as increasing physical activity, adopting a healthy diet, and enhancing strength, balance in older adults through simple daily exercises or simple activities like walking and dancing.
- Secondary Prevention involves identifying individuals who are at risk of falling or have already experienced a fall. It includes offering low level support, such as fall pendants, smalls aids and adaptations within the home to reduce the likelihood of future falls. Additional support may involve a home hazard assessment, safety interventions, and strength and balance exercise programs.
- Tertiary Prevention to support those who have already experienced significant consequences or injuries due to falls, with a focus on rehabilitation and ongoing support to maintain their health and reduce the risk of future adverse conditions.
Age Friendly Salford is a partnership that supports residents in leading healthy, active lives by raising awareness and providing activities like Walk and Talk sessions in parks and Brew and Chat gatherings. The partnership also assesses local organisations, businesses, community venues, outdoor spaces, and public transport against Age Friendly standards to create environments that are welcoming, responsive, and supportive of older adults' needs and wellbeing.