25 Jun 2020
Our Programme Development Manager for Healthy Ageing, Jane McDermott, suggests strength and balance exercise programmes are cost-effective and will achieve good outcomes with local populations.
Imagine being prescribed medication for high blood pressure but being told it’s only funded for 8 weeks? Dose for exercise needs to be treated the same as medication prescriptions!
Well-funded, co-created and joined up, community-based strength and balance exercise programmes, which start with the person, are vital in ensuring we can enjoy a healthy and well later life. But across England, inequality in local service funding provision directly impacts on who can access services, and who is left out of the loop.
We know from the recent Cochrane review that there is strong evidence that evidence-based strength and balance programmes reduce falls. We also know that these programmes are a key measure for reducing risk of falls – but implementation is patchy and under-funded.
Every year there are over 210,000 falls-related emergency hospital admissions in England which cost the NHS approximately £1 billion. For those experiencing a decline in their ability to do everyday activities, or who have already had a fall, referral into NHS rehabilitation services is critical to reduce risk of falling.
However, lack of funding means these programmes are often limited in length and fail to meet the correct dose to successfully achieve falls risk reduction. Imagine if your GP prescribed you medication for high blood pressure, but said it was only funded for 8 weeks!
In the two years to 2016, more than a quarter (28%) of adults over the age of 60 and nearly four in ten (35%) over the age of 80 reported a fall
Poor muscle strength and balance is known to contribute to an increase in falling. In the two years to 2016, more than a quarter (28%) of adults over the age of 60 and nearly four in ten (35%) over the age of 80 reported a fall. The impact of a fall is significant, affecting someone’s ability to complete activities of daily living, to engage in community activities and see friends. Perhaps most significantly, a fall often increases a person’s fear of falling, knocking their confidence, preventing them from wanting to leave or move around their home.
This impact on quality of life, socially, psychologically and physically can be enough to result in a rapid decline of somebody’s health and wellbeing, and often leads to early death.
In tandem with wider initiatives to help people to be more physically active as they age, funding strength and balance programmes in the community to support NHS rehabilitation programmes is a critical part of preventing further falls. It can also help ensure that the potential social and psychological impacts are managed and reduced.
Increasing community-based provision of strength and balance programmes to help an individual recover from a fall, or indeed to prevent a first fall, needs to be a shared responsibility.
From commissioners to Public Health directors; health and allied healthcare professionals to strength and balance exercise programme providers and instructors; as well as voluntary, public and private sectors. The responsibility for sustaining individual capacity as we grow older, and helping us rehabilitate after a fall, needs to be shared across a collaborative and agreed pathway. Falls are everybody’s business!
Yet despite what we know, strength and balance programmes continue to be underfunded, poorly organised, fragmented and inconsistent throughout England. Equally, whilst some people have access to good services, others fall through the loop; referral pathways are non-existent; rehabilitation programmes fail to reach accurate dose; lack of joined up thinking and delivery results in unjustifiable inequalities.
The evidence is clear, strength and balance exercise programmes are cost-effective and will achieve good outcomes with local populations. Pathways and services need to be funded and designed to enable the evidence-based dose to be achieved.