Falls are common after 50 — but they’re not an inevitable part of ageing. Here’s what actually reduces your risk, drawn together in one place.
The Evidence
Falls Aren’t Inevitable
A Cochrane review — the gold standard for evidence in healthcare — found that balance-and-task training combined with resistance exercise cuts the rate of falls by 34% and the number of people who fall by 22%. That’s not a marginal effect; it’s one of the most effective, evidence-backed things you can do to protect your independence.
The UK Chief Medical Officers put the guidance simply: exercise at least twice a week combining high-intensity resistance training, some impact activity (running, jumping, skipping) and balance training, tailored to the individual. It’s not about doing more of everything — it’s about doing the right combination, consistently. Public Health England’s return-on-investment modelling backs this up: the Otago programme — one-to-one strength and balance training — cuts falls by around 35%, and once the wider benefits to quality of life are counted, both Otago and FaME (Falls Management Exercise, a class-based UK model closer to what we offer) return over £2 in benefit for every £1 spent.
The WHO Framework
Three Ways to Reduce Your Risk
The World Health Organization frames effective falls prevention around three pillars — and real progress usually means working on more than one at once:
Safer People
Building strength, balance and confidence through regular exercise, reviewing medications that affect balance, and keeping on top of eyesight checks.
Safer Environments
Reducing hazards in the home — loose rugs, poor lighting, cluttered walkways — and making practical fixes room by room.
Safer Policies
Community programmes that make safer exercise genuinely accessible — exactly the role local, regular classes like ours are designed to play.
The Scale of the Problem in England
Falls and fractures among people aged 65 and over cause over 200,000 emergency hospital admissions and 4 million hospital bed days a year in England, costing the NHS roughly £2 billion (World Health Organization, 2021). The most recent National Hip Fracture Database report recorded 71,885 hip fractures across England, Wales and Northern Ireland in 2024 alone — up from 67,673 in 2019 — with one in 30 hospital beds occupied by someone recovering from one. Behind every one of those numbers is someone whose independence was affected — and, in most cases, whose risk could have been meaningfully reduced.
How Do You Know a Programme Is Any Good?
Not all falls-prevention exercise is equally effective. In 2019, Public Health England worked with the British Geriatrics Society, the Chartered Society of Physiotherapy, the Royal College of Nursing and the Royal Osteoporosis Society to define seven quality markers that separate a genuinely evidence-based programme from a general exercise class. Here’s what they look for — and what it means for what you should expect from any class you join.
A quality programme sits within a wider effort to increase physical activity across the whole population — not just isolated sessions handed out on their own.
Clear, documented referral routes and eligibility criteria — from a GP, physiotherapist, social prescriber or Fracture Liaison Service — so people who’d benefit can actually find their way in. It’s why we keep our own Ealing and Hillingdon referral pathways clearly signposted on our Medical Professionals page.
People at risk of falls should have access to programmes that are progressive, appropriately challenging and individualised for adequate duration and dose — not a generic routine everyone follows in exactly the same way.
Public Health England sets a benchmark of at least 75% attendance among those who begin a programme, as a real-world marker of quality — not just how many people sign up.
Progress should be tracked with standardised tests — the Timed Up and Go test, the 30-second chair-rise test, and the Falls Efficacy Scale — not attendance numbers alone. It’s part of why we use the same chair-rise test ourselves (see our Exercises at Home guide).
The job isn’t done when a programme ends — good provision supports people to maintain strength and balance activity suited to their own needs, preferences and abilities for the long term.
Source: Public Health England, Strength and balance quality markers: supporting improvement through audit (2019), endorsed by the British Geriatrics Society, Chartered Society of Physiotherapy, Royal College of Nursing and Royal Osteoporosis Society, among others. Our Otago-based Strength & Balance programme is built around this same framework — individualised, progressive, referral-friendly, and designed to be something you keep doing, not just complete.
Where to Go From Here
Explore Each Part of the Picture
Falls prevention isn’t one single thing — it’s a handful of areas working together. Here’s where to go for each one:
Exercises You Can Do at Home
Strength and balance exercises, self-tests to track progress, a room-by-room home safety checklist, and what to do if you have a fall.
Our Strength and Balance class follows the Otago approach, combining resistance and balance training in exactly the mix the evidence recommends — at a gentle to moderate pace with chair options throughout, and several of our instructors are PSI (Postural Stability Instructor) qualified. The WHO puts it well: effective falls prevention happens through “local ‘falls-prevention’ groups… achieved by collaborations with community-based exercise providers” — which is exactly the role we’re here to play across Ealing and Hillingdon.
Start Reducing Your Risk Today
A class built around the evidence, with an instructor who adapts it to you.
