A fall is "an event whereby an individual comes to rest on the ground or another lower level with or without loss of consciousness" - National Institute for Clinical Excellence (NICE) 2004
If an older person has fallen they should be screened for acute illness including a falls blood screen which involves Thyroid, Full blood count, Electrolytes, Liver function tests, Calcium, Vitamin B12 and folate.
Bristol Community Health seeks to support the Department of Health objectives to reduce the number of older people who fall and sustain injury by:
• Responding to a first fracture and preventing a second
• Early intervention to restore independence following a fall
• Preventing frailty, promoting bone health and reducing accidents
Bristol Community Health services are in day to day contact with older people and identify patients who need a multifactorial falls risk assessment using the following guideline:
"Older persons presenting for medical attention because of a fall report recurrent falls in the past year or report difficulties in walking or balance (with or without activity curtailment) should have a Multifactorial Falls Risk Assessment "American Geriatric Society/British Geriatric Society 2010.
The guidelines for the Multifactorial Falls Risk Assessment (MFRA) are in line with NICE guidelines, which can be found by clicking here.
The MFRA is also in line with the American Geriatric Society/British Geriatric Society guidelines, which can be accessed here.
We complete a multifactorial falls risk assessment which is central to communication with the GP and other staff and reduces duplication of assessment. This form can be found in the "Downloads" section to the left of this page.
The following services may be involved in assessment of falls risk and delivery of an intervention:
Out patient clinics in North Bristol NHS Trust or University Hospitals Bristol
Intermediate Care and Reablement - For falls associated with acute medical illness admission avoidance and multi-disciplinary rehabilitation
Community Healthcare teams - community matrons, community nurses, community nurses for older people
Community Therapy Services can provide:
Physiotherapy Domiciliary for a full balance assessment and physical/ mechanical issues related to falls , provision of evidence based exercise programmes, walking aids and advice for carers.
Occupational Therapy intervention within their own home for home hazard and Activity Daily Living assessment, equipment provision and advice for carers.
Physiotherapy - Musculoskeletal outpatient for post fracture management and musculo-skeletal conditions who can be seen in an outpatient clinic.
Falls Specialist nurse
This specialist community nurse will assess patients at home who:
• need comprehensive geriatric assessment to establish the cause of their falls
• remain at risk of recurrent falls after initial assessment and interventions
• have complex falls risks
The nurse will refer on to other services as necessary and following discussion with the GP if needed.
Written referrals can be made via confidential fax to 0117 9190296 or sent via post to
Ruth Cowell, Falls Specialist Nurse,
Knowle Clinic,
Broadfield Road,
Bristol BS4 2UH
Tel No: 0117 9190290
Mobile: 07767 220 976
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