Updated guidance moves away from prediction tools towards thorough personalised assessments for older people and those at higher risk.
Health professionals should abandon falls risk prediction tools and focus on wide-ranging assessments instead. That’s the key message from updated NICE guidelines published this year.
The National Institute for Health and Care Excellence has overhauled its approach to preventing falls in older adults. NICE guideline NG249, published on 29 April 2025, replaces the 2013 version with expanded coverage.
Who Gets Assessed
The guidance covers all people aged 65 and over, plus those aged 50 to 64 at higher risk of falls. But the approach has changed steeply.
NICE now explicitly states: do not use falls risk prediction tools to predict a person’s risk of falling. Instead, offer full falls assessments to people who meet specific criteria.
Those criteria include anyone who has fallen in the last year and is living with frailty, needed medical treatment for an injury, or lost consciousness during a fall.
What the Assessment Involves
A detailed falls assessment covers multiple areas. Healthcare teams check gait and balance, review medications, and conduct cardiovascular examinations.
The assessment also includes cognition checks, reviews of long-term conditions, and crucially – home hazard assessments. This multifactorial approach addresses the complex nature of falls risk.
All hospital inpatients and residential care residents should receive wide-ranging falls assessment and management. The guidance emphasises system-wide approaches using multidisciplinary teams.
The Shift in Thinking
The move away from prediction tools reflects growing evidence about falls prevention. Research suggests personalised, thorough assessments work better than standardised risk calculators.
Falls remain a large cause of illness and death in older people. Yet the new guidelines stress that effective prevention requires addressing multiple risk factors simultaneously.
Healthcare providers face changes to current practice. The guidelines require service adjustments and investment for consistent implementation across different care settings.
Patient advocates welcome the expanded scope to include 50-64 year-olds. Early intervention could help preserve independence, but accessible community services remain essential.
Source: @bmj_latest
Key Takeaways
- NICE guidelines now reject falls risk prediction tools in favour of complete personalised assessments
- All adults aged 65+ and higher-risk 50-64 year-olds are covered by the updated guidance
- Assessments must be multifactorial, including home hazard checks and medication reviews
What This Means for Kent Residents
Kent residents aged 50 and over who are concerned about falls should discuss their history with their GP practice. NHS Kent and Medway Integrated Care Board supports implementation through primary care networks and hospital services at East Kent Hospitals University NHS Foundation Trust and Maidstone and Tunbridge Wells NHS Trust. Local community falls prevention programmes offer balance training and home safety checks to help residents maintain their independence – speak to your GP about referral options if you’ve experienced falls or feel unsteady on your feet.