Falls Prevention in Senior Adult Oncology: Clinical Audit against NICE Guidelines (2025)

1. Introduction

Cancer and its treatments can increase falls risk in older adults due to fatigue, neuropathy, and muscle weakness (Guerard et al., 2015). The Senior Adult Oncology (SAO) service at The Christie provides Comprehensive Geriatric Assessment (CGA) and personalised interventions to this population. This audit evaluates SAO compliance with NICE Falls prevention guidelines (2025) for community‑dwelling older adults. Key aims include routine falls screening, delivery of a Comprehensive Falls Assessment (CFA) where indicated, and personalised interventions. The project aligns with the NHS 10‑Year Plan by promoting proactive, prevention‑focused care to improve outcomes for older adults. 

2. Method

• Systematic review of electronic patient records and extraction of data using bespoke form. 

• Data analysis to calculate percentage compliance with NICE guideline metrics (screened for falls risk, CFA, personalised interventions). 

• Descriptive statistics to profile common assessments and interventions. 

3. Results

• 49 eligible individuals; median age 79 (range 63-90), 25 (51%) had lung cancer, 30 (61%) on active cancer treatment. 

• 44 (89.8%) screened for falls.

• 20 individuals (40.8%) met CFA criteria, with frailty the most common indicator. 
• 20 eligible individuals (100%) offered CFA and personalised falls prevention interventions. 

Most frequently assessed domains were gait, balance, strength/mobility, cardiovascular examination, cognition, and dizziness. Less commonly assessed were alcohol misuse, footwear/foot health, hearing, and osteoporosis risk. The most common interventions delivered were falls prevention exercises, medication reviews, and Vitamin D supplementation advice.  

4. Conclusion(s)

89.8% of CGA attendees were screened for falls, leaving a small gap where at-risk patients may have been missed. The SAO service delivered CFAs and personalised interventions to eligible individuals. To reduce the burden of falls including injury, hospitalisation, and treatment delays, personalised prevention strategies should be integrated into geriatric oncology. Strengthening team education to embed guideline‑driven practice will support the aims of NICE and the NHS 10‑Year Plan.