NICE falls advice for GPs highlights pressure on 10-minute consultation

GPs should ask all older patients about falls or fear of falling during routine appointments, NICE has recommended.

GPs should ask during routine appointments with all patients aged over 65 if they have fallen in the last year or if they fear they are at risk of falling, NICE has said in its updated quality standard for preventing falls.

This could include quizzing patients on whether they ever lose balance or feel unsteady on their feet.

The recommendation comes in light of research that suggests a third (30%) of people in this age group will fall at least once annually.

But the RCGP warned that asking patients questions about falls will be difficult within the constraint of 10-minute appointments, which are becoming ‘increasingly inadequate’ for older patients with multiple long-term conditions.

RCGP chair Professor Helen Stokes-Lampard said: ‘The NICE standards released today highlight the importance of preventing falls in elderly patients, where possible, which is welcome.

Risk of fall

‘But implementing this new guidance will undoubtedly be hampered by the standard 10-minute GP consultation, which is increasingly inadequate, particularly for older patients who are often living with multiple, long-term conditions.

‘GPs want to spend longer with our older patients so that we can discuss things with them like how to avoid falling – but in many cases this won’t be the reason a patient has come to visit the GP, and it’s incredibly hard to do everything that we should do whilst respecting the patient and their reason for visiting us.

‘Nevertheless, it is essential that we do use all the opportunities we have with our older or more frail patients to establish whether they are susceptible to falling, and work with colleagues across health and social care to ensure they receive the most appropriate care and support. We also welcome initiatives that allow GPs to spend longer with patients with multiple health problems.’

Professor Gillian Leng, deputy chief executive at NICE, said: ‘We know that prevention is better than cure when it comes to falls, particularly in older people.

‘Asking older people about falls on a regular basis will identify those who are most at risk. Through this simple intervention, those people can then be referred to the right health care professional or service to stop them falling in the future.’

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