Falls

  • Quality standard
  • QS86
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Quality statement 3: Interventions to reduce the risk of falls

Quality statement

People aged 50 to 64 with 1 or more factors that could increase their risk of falls and people aged 65 or over have tailored interventions that address their individual risk factors if they need comprehensive falls management to reduce their risk of falling. [2017, updated 2025]

Rationale

A comprehensive falls assessment allows a person's risk factors to be identified. In a comprehensive falls management approach, interventions to reduce the risk of falls are tailored to address the person's individual risk factors.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Process

Proportion of people aged 50 to 64 with 1 or more factors that could increase their risk of falls and people aged 65 or over have tailored interventions that address their individual risk factors if they need comprehensive falls management to reduce their risk of falling.

Numerator – the number in the denominator who have received tailored interventions to reduce their risk of falling.

Denominator – the number of people aged 50 to 64 with 1 or more factors that could increase their risk of falls and people aged 65 or over who need comprehensive falls management.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.

Outcome

Injuries due to falls in people aged 65 and over (age-sex standardised rate of emergency hospital admissions for injuries due to falls in people aged 65 and over per 100,000 population).

Data source: The UK government's Public health outcomes framework (available at integrated care board level) reports emergency hospital admissions due to falls in people aged 65 and over (indicator C29).

What the quality statement means for different audiences

Service providers (such as specialist services, primary care services, community teams) ensure that systems and governance structures are in place to provide tailored interventions that address people's risk factors when they are identified through comprehensive falls assessment; to coordinate interventions across different professionals and settings; and to ensure that appropriate staff perform the interventions.

Healthcare professionals (such as consultant geriatricians, nurses, physiotherapists, occupational therapists, pharmacists and primary care practitioners) identify interventions that address a person's multiple risk factors established through a comprehensive falls assessment; discuss the interventions with the person and how they can be tailored to their needs; deliver the interventions; and document them in the patient's record.

Commissioners ensure that they commission services so that adults who are assessed as being at increased risk of falling receive tailored interventions based on comprehensive falls assessment.

People aged 50 to 64 with 1 or more factors that could increase their risk of falls and people aged 65 or over who have had an assessment that shows they are at increased risk of falling develop a plan with a healthcare professional tailored to their individual needs to reduce their risk of falling. This plan may include treating health problems, making changes at home, exercises, having their eyes checked and looking at whether any medicines they take should be changed.

Source guidance

Falls: assessment and prevention in older people and in people 50 and over at higher risk. NICE guideline NG249 (2025), recommendation 1.2.3, 1.3.1 to 1.3.11 and 1.3.15 to 1.3.25

Definitions of terms used in this quality statement

Fall

A fall is defined as an unexpected event which causes a person to rest on the ground, floor or lower level. [Adapted from NICE's guideline on falls; evidence review B, table 1]

People who need comprehensive falls management to reduce their risk of falling

People aged 50 to 64 with 1 or more factors that could increase their risk of falls and people aged 65 or over who are:

For people aged 50 to 64, factors that could increase the risk of falls include long-term health conditions that impact on a person's daily life such as arthritis, dementia, diabetes or Parkinson's disease; having had a stroke; and having a learning disability. [Adapted from NICE's guideline on falls, terms used in this guideline; factors that could increase the risk of falls and recommendations 1.1.3 and 1.1.7]

Tailored interventions

Comprehensive falls management involves using interventions tailored to address the person's individual risk factors identified in a comprehensive assessment. Individual interventions may be directly carried out by 1 or more health professionals in a specialist service (for example, a medication review by the team pharmacist or a home hazard modification by the team occupational therapist) or by referrals for further action (for example, a referral to ophthalmology for consideration of cataract surgery) and may vary depending on setting.

Comprehensive falls management interventions may include:

  • a structured medication review with modification or withdrawal, in particular, of psychotropic medicines

  • advice about vitamin D supplements

  • home hazard assessments and interventions

  • surgical interventions for cataracts or cardiac pacing

  • falls prevention exercise programmes

  • cognitive behavioural approaches

  • advice about physical activity and exercises.

[Adapted from NICE's guideline on falls, recommendations 1.3.1 to 1.3.11 and 1.3.15 to 1.3.25]