Falls are one of the most frequent 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), in partnership with the British Geriatrics Society (BGS), launched a new national Falls Governance Framework to strengthen how ambulance services and system partners respond to falls in the community.
The framework was developed to support integrated, person-centred care for older people and those living with frailty who have fallen or are at risk of falling. It reflects the NHS 10 Year Plan’s ambition to shift care from hospital to home, from analogue to digital, and from reactive treatment to proactive prevention.
Anna Parry, Managing Director of AACE, said:
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.
The framework was shaped by clinical leads for falls across all UK ambulance services and is endorsed by the British Geriatrics Society. It aligns with the priorities set out in NHS England’s Urgent and Emergency Care Plan for 2025/26 and offers practical guidance for ambulance trusts, commissioners and community providers.
This includes delivering evidence-based care for people who have fallen, integrating falls prevention and frailty services across neighbourhood teams, supporting remote assessment and digital triage, enabling safe non-conveyance to emergency departments, and promoting independence through proactive care planning.
Professor Jugdeep Dhesi, President of the British Geriatrics Society, welcomed the framework as a vital step in embedding frailty-aware, multidisciplinary responses to falls.
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 £2.3 billion each year, with around 75% of that burden arising in social care, home and community settings. 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 outlines five key domains for safe and effective falls management: prevention through awareness and signposting; building community resilience with timely, non-ambulance responses; assessment and remote care using digital platforms; coordinated urgent care to avoid unnecessary conveyance; and reducing recurrence through risk assessments and care planning.
Ambulance services receive up to 10% of 999 calls related to falls, yet current triage systems and fragmented referral pathways often limit the ability to deliver timely, joined-up care. The framework calls for greater interoperability, clearer roles and shared clinical governance across systems. AACE and BGS have urged 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 nearing end of life.
The AACE Falls Governance Framework is now available online and ready to support practice across the sector.
