For local authorities, integrated care boards, NHS trusts, housing providers and funders. WONDER delivers community physiotherapy and early-intervention rehabilitation for older people and people living with neurodegenerative conditions.
Every figure on this page is quoted from a named UK public source and links back to it.
Falls and deconditioning are among the largest single drivers of unplanned admission and of the transition from independent living into long-term social care. Physiotherapy and early-intervention rehabilitation act on that pathway before the transition happens.
of the £4.4bn total cost of fragility fractures to the UK is social care spend. Hip fractures account for around £2bn of the total.
Source: PHE, Falls and fracture consensus statement, January 2017falls-related emergency hospital admissions in England each year among patients aged 65 and older.
Source: PHE, Falls and fracture consensus statement, January 2017people aged 65 and over fall each year, increasing to half of those aged 80 and over.
Source: PHE, Falls and fracture consensus statement, January 2017projected rise in public expenditure on social services for older people between 2015 and 2040 under the current funding system.
Source: PHE / York Health Economics Consortium, The older adults' NHS and social care return on investment tool, January 2020“A substantial proportion of people who fall will be unable to return to independent living, being discharged into a residential care or nursing home.”Source: PHE / YHEC falls prevention ROI tool, February 2018
“A central goal of community-based interventions is to prevent, reduce or delay use of residential and hospital-based care.”Source: PHE / YHEC older adults ROI tool, January 2020
“Assisting people with healthy ageing will reduce the future costs of health and social care.”Source: PHE / YHEC falls prevention ROI tool, February 2018
“Effective commissioning for falls and fracture prevention will reduce demand and improve quality and outcomes.”Source: PHE, Falls and fracture consensus statement, January 2017
reduction in the rate of falls from evidence-based exercise programmes involving strength, balance and functional exercises.
Source: Chartered Society of Physiotherapy, Physiotherapy works for falls: a community approach, August 2019reduction in falls from providing multifactorial falls risk assessments.
Source: Chartered Society of Physiotherapy, Physiotherapy works for falls: a community approach, August 2019Community strength and balance programmes are exactly what Public Health England and the National Falls Prevention Coordination Group ask commissioners to provide, alongside multifactorial risk assessment and home hazard assessment. Falls and fracture consensus statement
Public Health England and the York Health Economics Consortium modelled four falls prevention programmes from an NHS and social care perspective over a two-year time horizon. WONDER's group programmes are closest in design to FaME.
Otago (home exercise)
FaME group exercise
Tai Chi group exercise
Home assessment and modification
| Intervention | Financial ROI | Societal ROI |
|---|---|---|
| Otago (home exercise) | £0.95 : £1.00 | £2.20 : £1.00 |
| FaME group exercise | £0.99 : £1.00 | £2.28 : £1.00 |
| Tai Chi group exercise | £0.85 : £1.00 | £1.97 : £1.00 |
| Home assessment and modification | £3.17 : £1.00 | £7.34 : £1.00 |
Read these numbers honestly.
Over a two-year horizon, group exercise is close to break-even in pure cash terms (£0.99 returned per £1 spent for FaME). The £2.28 societal return includes the quality-of-life gain to participants. Of the four programmes modelled, only home assessment and modification produced a positive financial return within two years.
PHE is also explicit that “the majority of these returns are not expected to be cash releasing but rather are opportunity cost savings (eg freeing up hospital beds due to a reduction in inpatient admissions)”. The case for community rehabilitation is demand reduction and independence maintained, not an immediate line-item saving.
100%
of participants felt more mobile after our 4-week course
Full participant numbers, course dates and our wider evaluation data are available to commissioners and funders on request.
Our full partnership proposal and fact sheet is available on request. It covers our service model, delivery capacity, safeguarding and governance, and the evidence base summarised above.
Request the proposalCommissioning a service, scoping a referral pathway, or considering us for a grant? Tell us what you need and we will come back with delivery detail and costs.