Authors: Report prepared by Dr Finbarr C Martin, MD MSc FRCP Consultant Geriatrician, Guys and St Thomas’ NHS Foundation Trust Associate Director for Falls and Bone Health, Clinical Effectiveness and Evaluation Unit, Royal College of Physicians Dr Jonathan Treml, BA, MBBS, FRCP Consultant Geriatrician, University Hospitals Birmingham NHS Foundation Trust Associate Director for Falls and Bone Health, Clinical Effectiveness and Evaluation Unit, Royal College of Physicians Mrs Janet Husk, RGN, MSc, Dip Project Manager, National Falls and Bone Health Audit, Clinical Effectiveness and Evaluation Unit, Royal College of Physicians Mr Robert Grant, BSc, Dip Stat Medical Statistician Clinical Effectiveness and Evaluation Unit, Royal College of Physicians Ms Michelle Spencer-Williams, BA Project Co-ordinator, National Falls and Bone Health Audit, Clinical Effectiveness and Evaluation Unit, Royal College of Physicians.

We present the results of the second national audit which examines the organisation of services provided to older people for falls prevention and bone health. Falls and fractures are a common and serious problem affecting older people, with high levels of personal and financial cost. National guidelines, supported by the research evidence, require the provision of integrated services for falls and fracture prevention and treatment. Effective commissioning is needed to produce such high quality services.

This audit was commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the second cycle of audits on services for the prevention of falls and fractures in older people. It follows the first organisational audit, performed in 2005, and the clinical audit of 2007. All were audited against specific standards from the National Service Framework for Older People (NSF) and guidance from the National Institute for Health and Clinical Excellence (NICE). Since the first audit, indicators have been added or updated in line with new guidance including that on falls prevention of inpatients following the National Patient Safety Agency (NPSA) report on slips, trips and falls in hospital (2007). For the first time, the audit also looks specifically at falls and fracture prevention in mental healthcare and a sample of care homes.