NICE seeks nurse opinions on falls guidance | Nursing Times

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The organisation which publishes health guidance in the UK is seeking to update its best practice for preventing falls in older people, and is asking for input from nurses.

The National Institute for Health and Care Excellence (NICE) has opened a public consultation on its new draft guidance for the prevention of falls in older people and people aged 50 and over who are at high risk.

“Falls present a major, growing public health problem which can have devastating consequences"

Jonathan Benger

Chief among the changes in NICE’s draft guidance are a series of recommendations for how to care for people at risk of falls in residential care settings, a first for the guidance.

As well as this, the new guidance recommends healthcare professionals perform a “comprehensive falls assessment” for anyone who has fallen in the past year and is frail, was injured in the fall, lost consciousness in the fall, were unable to get up independently or have had two or more falls.

This assessment, the draft guidance says, may include checking the patient's balance and gait, assessing their urinary continence, performing a cardiovascular examination, checking for visual or hearing impairments and reviewing their medication.

The patient's individual risk factors should then inform a plan of interventions to reduce their risk of falls.

Other changes to the guidelines include specifying that home hazard assessments should be carried out by an occupational therapist specifically, not just any healthcare professional, because of evidence that this further reduces the rate of falls.

However, NICE acknowledged that some areas in the country had a shortage of occupational therapists, and said it welcomed feedback on this recommendation in particular.

NICE chief medical officer and deputy chief executive Professor Jonathan Benger said that he hoped updating the guidance could help improve practice, and thus decrease the number of falls.

“Falls present a major, growing public health problem which can have devastating consequences for older people, their families and the healthcare service,” said Professor Benger.

According to NICE, there were around 210,000 emergency hospital admissions for people aged 65 and over relating to falls in England in the 2022-23 financial year.

Of these, more than half (146,700) were among people aged 80 or older and the organisation estimated that the annual cost of fragilty fractures to the UK to be £4.4bn.

He continued: “Fewer people suffering falls will result in a drop in the number of hospital visits and the need for ongoing treatments which will reduce pressure on the NHS.

“We recognise that recommending people at the greatest risk of falls should be offered a home hazard assessment carried out by an occupational therapist would be a change to current practice, so we want to hear from clinicians and others in the health and care system to get their views as part of the consultation.”

The consultation on the draft guidance runs until Thursday, 28 November.

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