Strength and balance programmes that help people at risk of falls are postcode lottery

Exercise programmes designed to boost the muscle strength and balance of people at risk of falls and injury – such as resistance training, aerobics classes and yoga groups – are not being prioritised by the NHS and local authority commissioners.  

A new report argues NHS falls rehabilitation services often don’t have the funding or ability to themselves provide strength and balance programmes for more than a few hours over just 6-8 weeks, much less than the 50+ hours over six months needed to make a difference to a person’s ability to do everyday activities.  

The issue can be exacerbated by referral pathways from the NHS to community-led programmes being unclear, with Clinical Commissioning Groups, local authorities and charities failing to join up with one another. A lack of consistent provision can limit the opportunities for people to take up strength and balance training and exercise programmes that will have a real impact on their wellbeing.

Muscle weakness and poor balance are the two most common modifiable risk factors for falls, which can lead to injuries such as hip fractures and make people more likely to end up in hospital or need social care. Hip fractures alone cost the NHS around £1 billion per year.  

Strength and balance activity can mitigate these risks and can lower the chance of suffering a fall, improve energy levels, mood and sleeping patterns and reduce the risk of early death.  

The report shows that, for adults with declining mobility and those experiencing a loss of muscle and bone strength or balance, there can be a corresponding decline in their ability to manage everyday activities like eating, bathing and getting dressed on their own.  

The report recommends that NHS and local authorities support evidence-based programmes, making sure that the most effective approaches to improving strength and balance are accessible and affordable for everyone. Making people aware of the benefit of strength and balance exercises should be a priority, and commissioners must work together to reinforce the information given to patients. There also needs to be improved collaboration between those referring people to programmes and those delivering them.  

“Improving and retaining strength and balance is vital for our wider health. Despite common misconceptions, falls are not an inevitable part of ageing and can be prevented. Evidence tells us that strength and balance programmes reduce the risk of falls, but lack of communication and effective referral pathways can mean poor or non-existent provision.  

“If we can enable and encourage more people to take up activities to boost their strength and balance, there is significant potential to make savings to health and social care services and help people stay healthy and keep on doing everyday activities for longer.”

“Making people aware of the benefit of strength and balance exercises should be a priority.  Prevention is absolutely central to the NHS Long Term Plan, which emphasises a move away from simply treating disease to a system that helps to keep people healthy for longer.  

“Our project shows that if the Long Term Plan’s ambition is to be realised, there needs to be a step change in the way strength and balance training is organised so that it is implemented effectively across the NHS in partnership with local government and the third sector.”