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Falls are one of the most common reasons for 999 calls and a leading cause of injury, hospital admission, and loss of independence among older people.
During Falls Prevention Awareness Week in September, the Association of Ambulance Chief Executives (AACE), working with the British Geriatrics Society (BGS), launched a new national Falls Governance Framework. The initiative aims to strengthen how ambulance services and system partners respond to falls in the community.
The framework is designed to support integrated, person-centred care for older people and those living with frailty who have fallen or are at risk of falling. It aligns with the NHS 10 Year Plan’s goals of shifting care from hospital to home, embracing digital solutions and focusing on proactive prevention rather than reactive treatment.
“This framework supports ambulance services and Integrated Care Systems to work together to deliver timely, compassionate and clinically safe care, reducing avoidable admissions and improving outcomes for patients.”
Anna Parry, Managing Director, AACE.
Developed by clinical leads for falls across all UK ambulance services, the framework is endorsed by the British Geriatrics Society. It provides practical guidance for ambulance trusts, commissioners, and community providers, covering evidence-based care for people who have fallen, integration of falls prevention and frailty services within neighbourhood teams, remote assessment and digital triage, safe non-conveyance to emergency departments, and proactive care planning to maintain independence.
Professor Jugdeep Dhesi, President of the British Geriatrics Society, said the framework was a vital step towards frailty-aware, multidisciplinary care.
“It recognises the complexity of falls and the need for joined-up care across ambulance, primary, community and voluntary services. With an ageing population, we must act now to prevent avoidable harm and support older people to live well at home.”
Falls cost the NHS over £2.3bn each year, with around 75% of that burden falling on social care, home, and community services. One in three people aged 65 and over, and half of those aged 80 and over, fall each year. Among major trauma patients, low-level falls are the leading cause of injury in older adults, often resulting in hip fractures, brain injuries, and long-term disability.
The framework sets out five key domains for falls management: raising awareness and prevention, building community resilience with timely non-ambulance responses, assessment and remote care using digital tools, coordinated urgent care to avoid unnecessary conveyance, and reducing recurrence through risk assessments and care planning.
Ambulance services handle up to 10% of 999 calls related to falls. Current triage systems and fragmented referral pathways, however, can limit the ability to provide timely, coordinated care. The framework calls for better interoperability, clearer roles and shared clinical governance across systems.
AACE and BGS are urging commissioners, providers, and local authorities to adopt the framework and work collaboratively to improve outcomes for people who fall, particularly those living with frailty or approaching end of life.
The AACE Falls Governance Framework is now available online and ready to support practice across the sector.
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