Research article

A national survey of services for the prevention and management of falls in the UK

Sarah E Lamb^1,2 , Joanne D Fisher³ , Simon Gates¹ , Rachel Potter¹ , Matthew W Cooke³ and Yvonne H Carter³

¹  Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK

²  Kadoorie Critical Care Research Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK

³  Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK

author email corresponding author email

BMC Health Services Research 2008, 8:233doi:10.1186/1472-6963-8-233

Published:	12 November 2008

Abstract

Background

The National Health Service (NHS) was tasked in 2001 with developing service provision to prevent falls in older people. We carried out a national survey to provide a description of health and social care funded UK fallers services, and to benchmark progress against current practice guidelines.

Methods

Cascade approach to sampling, followed by telephone survey with senior member of the fall service. Characteristics of the service were assessed using an internationally agreed taxonomy. Reported service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE).

Results

We identified 303 clinics across the UK. 231 (76%) were willing to participate. The majority of services were based in acute or community hospitals, with only a few in primary care or emergency departments. Access to services was, in the majority of cases, by health professional referral. Most services undertook a multi-factorial assessment. The content and quality of these assessments varied substantially. Services varied extensively in the way that interventions were delivered, and particular concern is raised about interventions for vision, home hazard modification, medication review and bone health.

Conclusion

The most common type of service provision was a multi-factorial assessment and intervention. There were a wide range of service models, but for a substantial number of services, delivery appears to fall below recommended NICE guidance.