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Millions wasted on falls clinics, claims report

By Emma Wilkinson

The NHS spends £32.5m a year on falls clinics, yet they appear to have ‘negligible clinical effect', a new report concludes.

Clinics cut recurrent falls by only 10% and appear to actually drive up follow-up attendances to GP surgeries, found the researchers, commissioned by the National Institute for Health Research.

The research team found wide variation in the clinics' organisation, staff skill mix, screening procedures and management of patients, despite 2004 NICE guidelines recommending how they should be run.

Falls clinics had no effect on mortality, hospitalisation or transition to institutional care. Just over half provided follow-up care, with others referring patients on to GPs, consultants or pharmacists – with a resultant overall increase in GP attendance.

Study leader Dr Simon Gates, principal research fellow at the University of Warwick clinical trials unit, said the report had tried to quantify what was going on with falls services in the NHS. ‘A lot of these clinics have been set up, but there's very little consistency and we are a bit in the dark about how effective they are.

‘There's doubt about how big a reduction in falls can be achieved, what the costs are and what the optimal method for assessing falls risk is.'

Dr Gates added that another study on screening for risk of falling due to be published shortly found the most widely used screening tool in NHS clinics was one with no evidence of effectiveness.

Dr Steve Iliffe, a member of the NICE guideline development group on falls in the elderly and co-director of the UCL centre for ageing and population studies, said the process recommended by NICE ‘haven't happened properly yet'.

‘GPs should refer people to the falls clinic but it's always an idea to do a work up beforehand so you have an idea of what you're

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