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3 February 2010
The Department of Health has published an economic evaluation which models the costs and benefits from establishing a fracture prevention service to reduce the risk of secondary fractures among older people, as described in the guide Falls and fractures: effective interventions in health and social care.
In this model, over a 5 year period £290,708 is saved in NHS acute and community services and local authority social care costs, against an additional £234,181 revenue costs (falling both in year 1 and covering drug therapy for five years spent by the NHS on this patient cohort). This is for an annual patient cohort of 797 hip, humerus, spine and forearm fractures, anticipated from a 320,000 population. At a national level, this equates to approximately £8.5 million saving over 5 years.
Action
Local communities can use these publications to develop their own proposals for a fracture prevention service. Healthcare professionals should also be familiar with the NICE clinical guideline on the assessment and prevention of falls in older people (>65 years) which provides advice on case identification and multifactorial falls risk assessment. It recommends that all older people with recurrent falls, or assessed as being at increased risk of falling, should be considered for an individualised multifactorial intervention, including strength and balance training, home hazard assessment and intervention, vision assessment and referral, and medication review with modification or withdrawal.
Several other downloadable prevention package resources are also available designed to support PCTs, SHAs and local authorities in prioritising and effectively commissioning services that support the health, well-being and independence of older people. These include information on existing health ‘entitlements’ including sight tests, flu vaccination and cancer screening; measures to improve access to affordable footcare services; an update on national intermediate care guidance; and a summary of existing progress on audiology and telecare. Each resource may be read as a stand-alone document or as part of the series.
More information on the management of osteoporosis can be found on NPC and in a recent MeReC Bulletin. These resources include some information on falls prevention.
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