Falls and Fragility Fractures Pathway

The Falls and Fragility Fractures Pathway defines the core components of an optimal service for people who have suffered a fall or are at risk of falls and fragility fractures.

The Falls and Fragility Fractures Pathway has been developed in collaboration with the National Clinical Director for Musculoskeletal Services, Peter Kay, Public Health England (PHE), the National Osteoporosis Society (NOS) and a range of other stakeholders from across the health and care system. The pathway defines the key interlocking components for an optimal system for prevention and management and the priority higher value interventions that systems should focus on to address variation, improve outcomes, reduce cost and contribute toward a sustainable NHS.

Central to the guidance provided by the Pathway is a falls and fractures National Consensus Statement and Resource Pack published by Public Health England in January 2017. The resources in the pathway also draw on a range of other national guidance and contain examples of best practice from across England to help make change on the ground.

The Pathway contains a number of key messages for commissioners and to emphasise their importance when using this product, they are included here:

Commissioners responsible for Falls and Fragility Fractures for their population should:

  • focus on the three priorities for optimisation
    • Falls prevention
    • Detecting and Managing Osteoporosis
    • Optimal support after a fragility fracture
  • work across the system to ensure that schemes to deliver the higher value interventions are in place
    • Targeted case-finding for osteoporosis, frailty and falls risk
    • Strength and balance training for those at low to moderate risk of falls
    • Multi-factorial intervention for those at higher risk of falls
    • Fracture liaison service for those who have had a fragility fracture,
  • use the Falls Prevention Consensus Statement and Resource Pack, especially the implementation checklist – there are links to the relevant sections throughout this resource

Local health economies can use this resource as a framework for their local improvement discussions, particularly during the ‘What to Change’ phase of their RightCare work.

NHS RightCare Pathways form part of the NHS RightCare Intelligence Programme