UK National Health Service Hospital-Based Falls Prevention Services: Progress, Delays and Challenges

Falls and high fall risk in older adults are key signals of unmet underlying health issues as well as further fall recurrence and injury. With reference to contemporary National Institute of Health and Care Excellence (NICE) guidance, World Guidelines and National Audit of Inpatient Falls (NAIF) reporting data, this commentary presents an analysis of current progress, opportunity and forward challenge in service implementation and delivery for two focused key UK National Health Service (NHS) hospital-based groups-(1) Hospital inpatients and (2) Accident and Emergency (A&E) attendees-target groups with UK evidence of preventative and health benefit from prompt comprehensive assessment and management. For inpatients, the National Audit of Inpatient Falls (NAIF) is an operational evidence-based hospital service resource delivering and monitoring progress at the NHS national and trust level. For hospital A&E attendees with a fall, the basis for a comparable, consistent, cost-effective NHS falls prevention service design and audit process is demonstrable from UK research evidence, but unresolved challenges in service implementation remain, and a standardised audit system is still lacking. Forward strategies involving clear leadership and audit are proposed.