This latest report from the National Audit of Inpatient Falls (NAIF) is the first to include inpatient fall-related injuries beyond hip fractures, following the introduction of a new case ascertainment process in 2025. Based on data from 4,191 inpatient falls resulting in injury across England and Wales, the report examines both preventative care before a fall and the quality of care provided afterwards.
Significant improvements are still needed in post-fall management, particularly in effective checks for injuries and medical examination
It found that only one-third of patients received a high-quality multifactorial assessment before the fall that caused their injury, while delirium screening and recording of key assessment measures remain low.
For the first time, the audit measured timely pain management, finding that fewer than four in ten patients received analgesia within 30 minutes of their fall. The expanded audit also suggests that patients with pelvic ring, vertebral and rib fractures may receive poorer post-fall care than those with other injury types.
While most Trusts and Health Boards have established falls governance arrangements and quality improvement activity, variation remains in workforce training, case ascertainment and organisational oversight. The report calls for stronger governance and more consistent post-fall processes to support safer care and reduce avoidable harm.
