Find out about updated guidance on assessing and preventing falls in older people

the draft updated guidance on the assessment and prevention of falls in older people and people aged 50 and over at increased risk opens for public consultation today (October 18).

This is a comprehensive update of our 2013 guidance which, for the first time, includes specific recommendations for people in residential care, as well as updated recommendations on the assessment and care of people in hospital and community settings.

The updated guideline recommends providing comprehensive fall assessment and management for people who have fallen in the past year and are living with frailty, were injured in a fall, experienced fall-related loss of consciousness, have not able to get up independently after a fall. falling, or having had two or more falls.

Comprehensive falls assessment may include physical exams, checking a person’s balance and gait, and asking about possible dizziness. It also considers how each person’s risk factors can be resolved, improved or managed to reduce their risk of falling.

Following fall assessment interventions that may be recommended include a fall prevention exercise program and consideration of a home risk assessment.

NICE guidelines previously recommended home hazard assessments were carried out by a healthcare professional. However, the new draft guidelines now recommend that they be done by an occupational therapist.

We are particularly interested in hearing feedback on this change in recommendation as part of the consultation, noting that there may be a shortage of occupational therapists in some areas.

Our independent guidelines committee reviewed the evidence and economic models that showed there were fewer falls when an occupational therapist delivered hazard interventions in the home.

Home hazard assessment may include checking for potential trip hazards to reduce the risk of falls and practical interventions such as installing handrails.

Conditions that increase the risk of falls include long-term health conditions such as heart disease, dementia or hypotension.

Falls can happen at any age, but they become more common as people age. About a third of people 65 and older, and about half of people 80 and older fall at least once a year.

In 2022/23 there were around 210,000 emergency hospital admissions in England related to falls in people aged 65 and over. About 146,700 of these admissions were people aged 80 and over. The consequences of fracture are significant, with a mortality of between 18% and 33% one year after a hip fracture.

The total annual cost of fragility fractures in the UK has been estimated at £4.4 billion, including £1.1 billion for social care; hip fractures account for about £2 billion of that sum.

The inquiry closes on Thursday 28 November.