The National Audit of Inpatient Falls (NAIF) is designed to capture data from acute, community and mental health hospitals relating to falls, and is based on NICE guidance and advice from NHS Improvement (NHSI).
Hospital inpatients in England experienced a quarter of a million falls during the year 2015/16.1 These
were spread across acute, community and mental health hospitals. Falls are commonly reported patient
safety incidents and result in:
over 2,500 hip fractures2
loss of confidence and slower recovery, even when physical harm is minimal
distress to families and staff
litigation against hospital trusts
overall costs to hospitals of £630 million per year.
Acute illness, particularly in frail older people or those recovering from serious injury or surgery,
increases the risk of a fall in hospital. Patients are vulnerable to delirium, dehydration and
deconditioning, all of which affect balance and mobility, especially in unfamiliar surroundings. The
majority of falls occur among medical inpatients during the first few days after admission.
These circumstances mean that not all falls are preventable. However, successful implementation of
guidance from NICE may prevent 20–30% of falls.4 Prevention depends upon prompt assessment to
identify potential risk factors, followed by clinical responses to ameliorate their effects. This is a complex
task requiring a multidisciplinary team approach. One patient may require several individually tailored
interventions. It also requires a patient safety approach throughout the organisation, with practical
support such as walking aids being always available, a culture of reliable incident reporting, and clear
accountability and commitment from senior leaders.
The National Audit of Inpatient Falls (NAIF) was designed to capture all these elements. It is based on
NICE guidance and advice from NHS Improvement (NHSI).