Handling falls

North West Ambulance Service NHS Trust (NWAS) commissioned a Behaviour Change Agency, to lead an insight research project to further understand the underlying issues related to high volumes of calls for emergency ambulance support, for incidents that were not serious or life-threatening.

Initial exploratory work with NWAS informatics team segmented the nature of calls and initial investigations highlighted nursing homes as being worthy of further research.  It was evident that there were high numbers of calls from this sector, with some nursing homes calling more frequently than others. Many incidents were categorised as 'falls', however, it was felt that many 'falls' were incidents that could be handled without requiring a 999 response from NWAS.

The research undertaken comprised of desk based research, primary quantitative and qualitative research with the target audience of paramedics working for NWAS as well as nursing home staff working across three target areas in the North West of Wigan, Bolton and Blackpool.  To contextualise the primary quantitative and qualitative research, researchers also conducted observational research during ambulance observations with paramedics across the North West area.


The following areas of best practice and improvements were identified from the key research findings.  The most effective ways in which to reduce the number of incidents from nursing homes were believed to be a combination of:

  • Sharing experiences
  • Implementing an evaluation process
  • Providing training for all staff members
  • Developing written materials to support the decision making process
  • Providing other written materials and information for other influencers
  • Aligning policies and procedures;

A summary of the findings from phase 1 is available download here.

Next Steps

NWAS have developed a training programme which is being delivered to Nursing and Care Home staff to empower and raise confidence when handling falls.  Desk based research, existing guidelines and standards together with information provided by NWAS colleagues and delegates from the event were used to develop training content.

The programme will deliver increased understanding of the appropriate care pathway in the event of a resident experiencing a fall, and how to manage falls within the home through assessing and monitoring residents.

The training programme is being delivered through a four-week pilot to test and trial three different approaches (which vary in format and support) to delivering this information across Nursing and Care Homes in Bolton, Wigan, Blackpool and Preston. The output of this pilot is primarily to gain qualitative feedback on the content and format of training resources to further refine resources for the programme roll out.


To access the online training package please download the following materials to the right.


For more information on any aspect of this project please contact communications@nwas.nhs.uk