Accidents, Injuries and Falls

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Joint Strategic Needs Assessment (healthysomerset.co.uk/JSNA)

Older People

As people age, they have an increased risk of falling – an estimated 30% of those aged 65 and up to 50% of those aged 80 fall each year.

More detail is to be found in the 2023 Falls Health Need Assessment.

A fall can lead to:-

• Complications arising from being unable to get up
• A loss of confidence
• Greater social isolation
• Becoming less physically active
• A loss of independence.  

However there are ways to address the likelihood of having a fall, which is not an inevitable consequence of ageing. Somerset County Council has produced a leaflet, Fall Stop, containing advice, useful websites and contact numbers.

Falls are the leading cause of mortality due to injury. In the UK 95% of hip fractures are as a result of a fall. Each hip fracture costs an estimated £10,000 to the NHS. In addition, due to the high levels of morbidity and disability associated with hip fractures, the costs following discharge to local authority social care are also considerable.  

• It has been estimated that there are about 13,000 falls a year in Somerset
• In Somerset, there were a total of 3,285 emergency admissions of people aged 65 and over for falls in 2019/20, of these 2,280 were for people aged 80 and above.
• Emergency admissions for hip fractures in people aged 65 and over fell to a total of 830 admissions in Somerset in 2019/20, including 605 for those aged 80 and over. 
• In 2019/20, the rate per 100,000 people of emergency admissions for hip fractures aged 65+ for injuries due to falls in Somerset (569) was almost identical to the national average rate (572).
• The average hip fracture costs almost £40,000 to the NHS.
• The common bone condition, osteoporosis, which affects both men and women, can increase the risk of a fracture if someone has a fall. Around one in two women may develop the condition.
• Falls and osteoporosis are inextricably linked and the development of the Somerset Bone Health Pathway (2014, based on the Bone Health Needs Assessment 2013) aims to:-
  • raise awareness of the importance of bone health,
  • enable increased identification of those who may be at risk of osteoporosis
  • ensure they receive appropriate treatment
  • screen for osteoporosis those who do fracture who are in ‘at risk’ groups.

Falls awareness is very important and is promoted throughout the county through various health, social care and voluntary providers who have contact with older people and groups such as the Somerset Active Living network. 

Basic risk assessments and raising awareness amongst older people are proven to be beneficial in identifying those who require further assessment, and can empower people to reduce their risk of a fall. 

Many falls can be prevented through simple measures which include:

• identification of hazards in the home
• modifications to the home environment for those at risk
• individuals encouraged to remain physically active, have regular sight checks, to report side-effects from medication such as dizziness, be aware of suitable footwear, and seeking help for foot problems or continence issues.

The Integrated Rehabilitation Service offer assessment and rehabilitation for people who have had a fall, or who have balance and mobility problems. In addition Balance and Safety groups are run in community hospitals. These eight week courses enable people to improve their balance and strength through weight bearing exercise and help address other issues which may place them at risk of a fall.

As previously mentioned a fear of falling can also be a factor in increasing vulnerability and falls risk, many people who have had a fall and up to 40% of those who have not had a fall may become less active as a result, with the decreased mobility potentially leading to increased social isolation. 

Although many falls occur in the home it is vital to consider how the design or maintenance of the outdoor environment may contribute to falls risks, also to identify and remedy environmental hazards in the community such as cracked, uneven and slippery paving, poorly designed steps and slopes.

The local authority plays an integral role in responding to these issues with responsibility for the wider services in the area, including pavements and public transport in partnership with relevant stakeholders and communities themselves.  

Children and Young People

The National picture

Injuries are a leading cause of hospitalisation and represent a major cause of premature mortality for children and young people. They are also a source of long-term health issues, including mental health related to experience(s).

In particular, unintentional injury in and around the home are a major cause of death and disability for children under 5 in England. These injuries result in approximately 40,000 emergency hospital admissions among children of this age each year. An average of 62 young children died of such injuries each year between 2008-2012.

Nationally, injuries are the leading cause of death for children aged 1-4 and 15-19 and is a leading cause of death amongst children and young people aged 4 – 14, second only to cancer. Around 2 million children and young people visit UK Accident and Emergency Departments each year as a result of a non-fatal injury.

Emergency hospital admissions caused by unintentional & deliberate injuries to Young People (rate per 10,000 aged 15-24)

Source: Public Health England Fingertips

*These figures are of uncertain reliability (see Public Health England Fingertips).

These statistics relate to the number of finished in-year emergency admissions of children and young people to hospital as a result of unintentional and deliberate injury per 10,000 population of children and young people.  ‘Unintentional’ injury is used here to mean accidental external causes of harm (e.g. traffic accidents, falls, trips, burns and scalds etc).  ‘Deliberate’ injury refers to the codes for assault (e.g. bodily force, sexual assault, sharp/blunt objects, etc).

Somerset Child Accident Prevention Strategy

Launched in 2016 by the Children and Young People Health & Wellbeing Group at Somerset County Council, the Somerset Child Accident Prevention Strategy will:-

• Raise the profile of accidental injury in children and young people (aged 14 and under) and highlight opportunities for prevention
• Highlight the extent and cost of accidental injury among children and young people nationally and in Somerset, indicating where inequalities exist
• Outline national and local priorities for action and relevant targets
• Provide recommendations for further action in order to reduce accidents in children and young people in Somerset, and to reduce inequalities
• Outline a Somerset model for future service delivery based on a partnership approach

As part of the strategy, a partnership of Somerset County Council, Devon and Somerset Fire and Rescue Service, Somerset Partnership NHS Foundation Trust Health Visiting Teams and getset family support workers have launched a ‘Safer Homes’ project to support families to prevent accidents in the home.

The ‘Safer Homes’ project identifies families who need additional support with child safety equipment. At 31st May 2016 there had been 65 visits to Somerset families through this scheme, which will continue through 2016-17.

See also Road Casualties amongst Children and Young People