Well last week’s weather was a
challenge for many. We had Red, Yellow and Amber warnings for large swathes of
the UK. The snow and the gales caused massive disruption for thousands of
people. At one stage, 3500 vehicles were trapped in the snowy and treacherous conditions
on the M62. Commuters were stranded overnight on trains, with no food, water or
power. Thousands of people had no power. Tens of thousands of flights were
cancelled. 80 yachts and boats were smashed to pieces in a marina on Anglesey.
Trees were brought down. Many people had multiple ‘snowdays’ or were able to
work from home. Yes it was a challenge.
Thankfully, I had plenty of food,
wine, and a warm house. Others weren’t so fortunate. I saw dozens of messages
on social media of people whose boiler had chosen last week to pack up and of
course the road conditions meant that there were long delays in engineers being
able to reach folk. There were heroes aplenty though. The RAC managed to attend
some 10,000 broken down vehicles a day. Local residents from areas around the
closed stretch of the M62 near Rochdale walked to the stranded motorists, with
food, blankets and enough hot lasagne for 1000 people. Tesco’s provided warmth
and blankets in some of their 24 hour stores. Up and down the UK, many NHS
staff either stayed overnight on wards or walked to their hospital to ensure patient
services were maintained. Those working in the community filled rucksacks with
supplies and walked to their patients’ homes, or travelled in 4x4s volunteered and
driven by local people.
I couldn’t get my car out for
several days (not that it would have been possible to get to many places).
Being housebound by the weather reminded me of winter in 1981/2. I was living
in rural Wales at the time. My house was at the end of a private farm track.
The track had tall hedges and trees on either side, and these trapped the
enormous falls of snow, causing drifts 15 feet and more deep. It took days
before a tractor came to and cleared the road. And then it was only possible to
travel on the snow covered roads by fitting snow chains to the car wheels; a
task that nearly always caused me to lose some of the skin off my fingers!
Although I couldn’t drive, I
could still go out dog walking. I have the right gear to keep me warm and dry.
At times, and in many places walking was precarious, with extremely slippery
icy conditions underfoot. These days I am very ‘fall aware’, so my approach to
dog walking was rather slow and cautious. Of course anyone can fall, but those
aged 65 and older have a much higher risk of falling. Some 30% of people older
than 65 and 50% of those aged 80 and above experience at least one fall a year.
There are 12 million people living in the UK aged 65 and over, which equates to
18% of the total population. That works out at around 255,000 falls-related emergency
hospital admissions a year. That is a lot of falls.
Such falls can result in physical
injuries such as head injuries, the extent of which can often be hidden,
fractures of other bones, and so on, including death. Just as importantly,
falls can result in a loss of confidence in being able to carry out the
activities of daily living; a fear of future falls, and the subsequent loss of
independence. Apart from these obvious personal impacts, for the NHS falls
account for more than four million hospital bed days. Fractures of the hip are particularly
challenging. The average length of stay is 21 days. Likewise, the evidence shows there is a 10%
risk of death at 30 days and a 30% risk of death at 1 year. In 2015, hip
fractures cost the NHS £1.1 billion pounds. Now it’s estimated that fragility fractures
cost the UK around £4.4 billion, of which 25% is for social care. This is a staggering
amount of money. My concern are over those costs involved in providing care for
those who have become socially isolated, lacking in confidence and who might be
living with extensive co-morbidities.
It was against this background
that last week I read the Public Health England publication that addressed what
might be cost effective investments in falls prevention programmes. The
publication reports on some extensive research that looked at four interventions
which if implemented could both save lives and money for the NHS. The four
evidence based interventions were: The Otago programme; the Falls Management
Exercise programme; Tai Chi exercises; Home Assessment and Modification (HAM) services.
You can find details of each of these interventions here. In terms of return on
investment for every £1 spent, the HAM programme showed a massive return from a
financial point of view and over twice as much from a societal return on
investment. As we know that the overall percentage of older people in the wider
population continues to grow, this news is very welcome indeed.
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