NICE Guidelines for the Assessment and Prevention of Falls in Older People

The part played by physiotherapy staff in preventing falls among older people in hospital could increase following the inclusion of a key recommendation in newly-updated guidance from the National Institute for Health and Care Excellence (NICE).  The NICE guidance, which applies to England and Wales, could mean more involvement for physiotherapists.

The National Institute for Health and Care Excellence (NICE) is calling on the NHS to reduce the number of older patients who are falling over in hospitals. Doctors and nurses should identify the individual risks of these patients to help reduce serious injury and death.  Falls cost the NHS an estimated £2.3 billion a year. Nearly 209,000 falls were reported in hospitals in England between 1 October 2011 and 30 September 2012. While the majority (97%) of these people experienced no or low harm (such as minor cuts and bruises), 90 patients died because of their falls. Around 900 patients experienced severe harm, such as hip fractures and head injuries.

This new clinical guideline extends and replaces NICE clinical guideline 21(published November 2004). It offers evidence-based advice on preventing falls in older people. New recommendations have been added about preventing falls in older people during a hospital stay.  All people aged 65 or older are covered by all guideline recommendations. People aged 50 to 64 who are admitted to hospital and are judged by a clinician to be at higher risk of falling because of an underlying condition are also covered by the guideline recommendations about assessing and preventing falls in older people during a hospital stay.

NHS trusts in the UK can choose how to implement the guidance, however physios are often asked to train nurses or other staff in conducting basic assessments for patients needing walking aids.  A similar recommendation was made in the Fallsafe report, which was published recently by the Royal College of Physicians.  This could have huge implications for physiotherapists, without an appropriate walking aid, patients either can’t mobilise, which is detrimental, or they mobilise in the wrong way.  The NICE guidance updates and extends existing advice on falls prevention to include people admitted to hospital.