Innovative new programme launched to reduce falls in The Netherlands

October 6, 2023

Standing Strong’, a falls prevention program for elderly citizens, was launched in December 2022 across seven municipalities in the Dutch province North-Limburg.

‘Standing Strong’ is a unique collaboration between health insurance companies, health providers, a long-term care administrator, municipalities and social investors. The programme, worth €2,8 million is funded through a ‘Health Impact Bond’, which combines crowdfunding from One Planet Crowd with social investment from BNP Paribas Social Impact Bonds Fund (created and managed by BNP Paribas Asset Management on behalf of the European Investment Fund (EIF) and BNP Paribas), Bridges Outcomes Partnerships, and Rabobank.

In North-Limburg 40% of the 40.000 inhabitants who are 70 of older experience a fall incident at least once a year. The number of serious injuries due to fall incidents is three times higher than average in The Netherlands. ‘Standing Strong’ – an intervention developed by Vilans and VeiligheidNL – addresses the urgent need to scale up efforts to reduce this high number of falls. A consortium under the direction of the Zorggroep is carrying out the programme, while Social Finance NL is involved as an intermediary and structured the Health Impact Bond with BNP Paribas as co-structurer.

Joining forces for upscaling

Last year, about 5,400 persons lost their lives because of fatal falls in the Netherlands. This number has doubled in the last ten years (source: CBS), and the number of fall incidents is expected to rise by a further 40%. in the coming years. Several small-scale interventions have proven to be effective in reducing the rates of falling among senior citizens at a local level – but there is an urgent need to scale these up and improve cooperation across the ecosystem.

‘Standing Strong’ will be the largest falls prevention program in the Netherlands. Over a five-year period, the program will screen the mobility and risk of falling of 7,000 seniors (aged 70 and above) from the region. 2,500 of these seniors with high risk of falling will then receive a targeted movement intervention, including customized support. This will result in fewer fall incidents and admissions to Accident and Emergency Services, while also leading to improvements in balance and muscle strength, and reduced dependency on homecare.

Health Impact Bond for fall prevention

The ‘Standing Strong’ program is unique in its scale, its structure and the level of collaboration between different stakeholders across the ecosystem. It is the first time in the Netherlands that such a program has been funded via a Health Impact Bond, in which social investors provide the upfront capital needed to deliver the falls prevention intervention. If the intervention is successful in achieving clearly-defined, measurable outcomes, this capital is paid back by the outcome payers: in this case the municipalities and the health insurance companies, who have committed to pay for these outcomes based on the longer-term cost-savings they will achieve as a result. BNP Paribas European Social Impact Bonds Fund, BridgesOutcomes Partnerships and Rabobank have jointly committed €2,55 million in the programme, with a revolving portion. The remaining €250.000 was crowdfunded from over 200 private investors through the platform Oneplanetcrowd.

Lucía Santirso Richards, Director at Bridges Outcomes Partnerships, said:

“We’re really excited to support this innovative program in North-Limburg. By bringing together stakeholders from across the whole system – insurance companies, municipalities, administrator, delivery partners – Standing Strong is an intervention that will address the urgent need to reduce falls in a very targeted and personalized way. Through this preventative approach, we can not only reduce the long-term costs of falls, but more importantly improve the lives of thousands of seniors in the Netherlands.”

Maha Keramane, Head of Positive Impact Business Accelerator BNP Paribas, said: “We are very proud to launch our very first health impact bond in the Netherlands to tackle one of the major issues of our aging society. Through adapted physical activity, this project experiments an innovative intervention model to prevent the number of falling incidents for at least 2500 elderly persons above 70 years old and to delay the state of dependency. Looking forward to the results in order to scale the initiative or to replicate it in other countries !”

Read more on initiatives BNP Paribas is deploying to promote the financial and social inclusion of the most vulnerable: Financial and social inclusion | BNP Paribas (