Falls Screening in England and Wales
Recognizing an urgent need to prevent inpatient falls in mental health settings, the Oxford Health National Health Foundation Trust led a review of the National Health Service mental trusts in England and health care boards in Wales. Fall risk prevention tools and policies were evaluated for alignment with the 2004 National Institute for Health and Care Excellence (NICE) fall prevention guidelines. Fall risk guideline adherence was evaluated for 35 mental health trusts. The St. Thomas’ Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY), Falls Risk Assessment Scale for the Elderly, Morse Falls Scale, and Falls Risk Assessment Tool (FRAT) were the main assessment tools used by the trusts. In some cases, the reviewers found that trusts were using versions of the FRAT and other tools which had not been validated in a mental health population. Only four of the trusts reported falls risk prevention programs that met all the recommendations of the NICE falls guidelines. Further, the 2013 update of the NICE guidelines recommend that numeric fall risk scales should no longer be used and should be replaced by multifactorial risk assessment and implementation of falls interventions that are tailored to specific patient populations and settings.
Narayanan V, Dickinson A, Victor C, Griffiths C, Humphrey D. Falls screening and assessment tools used in acute mental health settings: a review of policies in England and Wales. Physiotherapy. 2015;DOI:10.1016/j.physio.2015.04.010.
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