A national survey of services for the prevention and management of falls in the UK.
BACKGROUND
The National Health Service (NHS) was tasked in 2001 with developing service provision to prevent falls in older people. We carried out a national survey to provide a description of health and social care funded UK fallers services, and to benchmark progress against current practice guidelines.


METHODS
Cascade approach to sampling, followed by telephone survey with senior member of the fall service. Characteristics of the service were assessed using an internationally agreed taxonomy. Reported service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE).


RESULTS
We identified 303 clinics across the UK. 231 (76%) were willing to participate. The majority of services were based in acute or community hospitals, with only a few in primary care or emergency departments. Access to services was, in the majority of cases, by health professional referral. Most services undertook a multi-factorial assessment. The content and quality of these assessments varied substantially. Services varied extensively in the way that interventions were delivered, and particular concern is raised about interventions for vision, home hazard modification, medication review and bone health.


CONCLUSIONS
The most common type of service provision was a multi-factorial assessment and intervention. There were a wide range of service models, but for a substantial number of services, delivery appears to fall below recommended NICE guidance.
Lamb
Sarah E
SE
Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK. s.lamb@warwick.ac.uk
Fisher
Joanne D
JD
Gates
Simon
S
Potter
Rachel
R
Cooke
Matthew W
MW
Carter
Yvonne H
YH
D000058:Accidental Falls / Q000517:prevention & control*; D019985:Benchmarking; D005081:Exercise Therapy; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D010353:Patient Education as Topic; D011314:Preventive Health Services / Q000379:methods / Q000706:statistics & numerical data*; D006113:United Kingdom