NHS warning issued to UK homeowners over ‘hidden’ garden hazard

Around 255,000 falls-related emergency hospital admissions a year in England involve people aged 65 and over, with about 4 million hospital bed-days linked to those falls, according to a British Journal of Hospital Medicine review . The figures put a sharper focus on NICE’s current falls guidance, which tells services to look beyond indoor trip risks. Its public statement says home-hazard assessments can include checks in the home or garden, including uneven flooring and poor lighting.

The guidance covers all people aged 65 and over, as well as people aged 50 to 64 who are at higher risk of falling, according to NICE. It is aimed at reducing falls and the distress, pain, injury, loss of confidence, loss of independence and deaths that can follow. For households, the garden point matters because patios and paths often become everyday routes in warmer months, especially when doors are left open and outdoor seating is used more often.

NICE also reported around 210,000 emergency hospital admissions in England related to falls for people aged 65 and over in 2022/23, including about 146,700 among people aged 80 and over. Separate GOV.UK falls guidance says around a third of people aged 65 and over, and around half of people aged 80 and over, fall at least once a year. The same guidance describes falls as distressing and painful, with the ability to cause injury, loss of confidence, loss of independence and death.

The issue is not only about major hazards. A slightly raised slab, a slick strip of algae, a loose edging stone or a puddle that never drains can be enough to change someone’s footing. NICE’s public statement is clear that garden risks sit alongside indoor hazards, so a patio that looks tired can also be a safety concern.

There is also evidence that acting at home can reduce pressure on hospitals. UCL News reported that a personalised home-based service for mildly frail over-65s, led by Professor Kate Walters and funded by the NIHR, reduced unplanned hospital admissions by 35% and saved an average £586 per person to the NHS over one year. While that trial was not about paving, it supports the same practical idea: small, personalised changes at home can prevent bigger problems later.

A spokesperson from Britannia Stone, a spokesperson reviewing the guidance from a paving and landscaping materials perspective, explains: “The simple test is to walk the patio slowly after rain and look for changes underfoot. If water is pooling in the same place, green algae keeps returning, or one slab rocks when stepped on, that is a sign the surface is moving or not draining properly. A cheap spirit level or even a straight piece of timber can help show where slabs have lifted, dipped or started sending water back towards the house.”

Drainage matters for another reason: GOV.UK permeable surfacing guidance says householders do not need planning permission if a new or replacement driveway uses permeable surfacing or sends rainwater to a lawn or border, and says the advice can also apply to patios. The same guidance says impermeable front-garden surfacing over 5 square metres needs planning permission, while Planning Portal says a typical householder planning application in England costs £548, plus a £75.83 + VAT online service charge where the application fee is over £100. Before outdoor areas get heavier use, clear moss, check lighting, mark any loose slab, and get help for hazards that affect an older or at-risk person’s regular route.