Strengthening Preventative Care: Improving falls prevention advice for older people at the front door

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Peter Akinbobola1, Abi Byrchmore2, Minuri Paranagama3

1 Physiotherapy, 2 Queen Elizabeth Hospital, 3 University Hospitals Birmingham

Abstract

Introduction

210,000 emergency admissions were related to falls in people aged 65 and over in England 2022/2023¹. Many falls in older people are preventable.

New NICE guidance NG249, highlighted the need for patient education, recommending that clinicians ‘discuss ways that people can reduce their risk of falls as well as improving their overall wellbeing, and provide information that they can take away’²

The Older Persons Assessment and Liaison service (OPAL) at Queen Elizabeth Hospital Birmingham, provides an acute assessment service to frail older adults presenting in the emergency department (ED) including identification of falls risk factors.

Method

OPAL therapy assessments were reviewed for patients attending ED with a fall within a two-week period in March 2025. Data taken included: Falls risks identified in therapy assessment, If prevention advice was given, what risk factors were discussed

Intervention: Falls prevention leaflet was introduced to OPAL team. Therapists were encouraged to use the leaflet to provide advice for all patients with a fall and document that advice sheet was given.

The same data collection was repeated following intervention within a two-week period in July 2025.

Results

Initial data (n=47) showed that the OPAL team do not regularly give and document prevention advice to patients who have fallen as standard practice. Prevention advice was limited to a small number of risks, with mobility, postural hypotension and cognition most commonly discussed.

Post intervention (n=52) there is a small increase in the percentage of patients where prevention advice was given and documented. The prevention advice that was given covered significantly more of the falls risk factors assessed.

Conclusion

The introduction of a standardised falls prevention advice leaflet increased the range of prevention topics discussed with patients. This has the potential to improve NICE compliance of therapy treatments within the OPAL team.

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