National Institute for Health and Clinical Excellence (NICE)
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Take action to prevent repeat falls in older people

To improve the care of older people who have suffered a fall, the National Institute for Health and Care Excellence (NICE) has set out key priorities for consultation. The draft quality standard aims to help NHS staff prevent further injury in older patients who have had a fall.

Falling is the leading cause of injury-related death in people over 75 in the UK, and costs the NHS an estimated £2.3 billion per year.

Almost a third (30%) of adults over 65 and living at home will experience at least 1 fall a year, which is around 2.5 million people in England alone. Falls in hospital are the most commonly reported safety incidents, with an estimated number of around 282,000 patient falls in England each year.

In this new draft quality standard, NICE has set out priorities to ensure that older people who fall are thoroughly assessed and offered support to prevent subsequent falls. The standard includes 4 statements now open for public consultation:

  • NHS organisations with inpatient beds must have easily accessible ‘post-fall’ protocols that outline how to promptly and safely care for any older person who falls during their stay.
  • Doctors and nurses who see older people who have fallen refer them for specialist assessment to identify anything that might make them fall again and how it can be avoided in the future.
  • Older people with a history of recurrent falls are referred to an expert who will help them start exercises to build up their muscle strength and improve balance.
  • Older people who have received hospital treatment for a fall are offered a visit from a trained professional who can check their home for anything that can put them at risk of falling again.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: “Since publication of the NICE guideline in 2013 on preventing falls we have already seen a reduction in the numbers of people who suffer harm from a fall. With the introduction of this new quality standard we want to offer more advice to healthcare professionals to make sure that older people, who are at high risk of falls, are further protected. When a person falls, it is really important that they are thoroughly assessed and given help so they can manage when they are back at home, so they avoid suffering any further harm.

“This quality standard will help nurses, doctors and community healthcare providers who are committed to the NHS’s Sign up to Safety pledge to deliver harm free care for every patient. Every hospital fall costs on average £1,215. If we can reduce the recurrence of falls, people not only get safer care but it could also help achieve cost savings for the NHS.”

The draft quality standard is now open for public consultation until Wednesday 3 December 2014. It is not NICE’s final quality standard on falls. The statements are provisional and may change after consultation with stakeholders.

Registered stakeholders (such as professional and government organisations, patient and carer groups and companies) can register at any time during the development of the quality standard and submit their comments. Individuals are advised to pass comments on to the registered stakeholder that most closely represents them.

The final standard is expected to be published in May 2015.

For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.

Notes to Editors

Facts and figures

  • Approximately 5% of older people living in the community who fall experience a fracture or need hospitalisation.
  • Falls and fractures in people aged 65 and over account for over 4 million hospital bed days each year in England alone.
  • Each year around 282,000 patient falls are reported to the NHS England’s Patient Safety division from hospitals and mental health units. A significant minority of these falls result in death or in severe or moderate injury.
  • According to the latest NHS Safety Thermometer official statistics for England, in May 2014 0.7% of reported patients had a fall resulting in harm, compared with 0.9% in May 2013.

About the draft quality standard

  1. The draft quality standard is available at
  2. The draft quality standard is different to the institute’s falls guideline which was published last year and gives recommendations across broad areas of care to help assess and prevent falls in older people.

About NICE quality standards

NICE quality standards aim to help commissioners, health care professionals, social care and public health practitioners and service providers improve the quality of care that they deliver.

NICE quality standards are prioritised statements designed to drive measurable quality improvements within a particular area of health or care. There is an average of 6-8 statements in each quality standard.

Quality standards are derived from high quality evidence-based guidance, such as NICE guidance or guidance from NICE accredited sources, and are produced collaboratively with health care professionals, social care and public health practitioners, along with their partner organisations, patients, carers and service users.

NICE quality standards are not mandatory but they can be used for a wide range of purposes both locally and nationally. For example, patients and service users can use quality standards to help understand what high-quality care should include. Health care professionals and social care and public health practitioners can use quality standards to help deliver high quality care and treatment.

NICE quality standards are not requirements or targets, but the health and social care system is obliged to have regard to them in planning and delivering services, as part of a general duty to secure continuous improvement in quality.

Quality standard topics are formally referred to NICE by NHS England (an executive non-departmental public body, established in October 2012) for health-related areas, and by the Department of Health and Department for Education for areas such as social care and public health.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

Our products and resources are produced for the NHS, local authorities, care providers, charities, and anyone who has a responsibility for commissioning or providing healthcare, public health or social care services.

To find out more about what we do, visit our and follow us on Twitter: @NICEComms.


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