Falls in hospital are the most commonly reported patient safety incident in the NHS, with approximately 250,000 reported each year. Many are unpreventable. But a significant number result from a failure to identify the patient's falls risk, to implement appropriate precautions, or to respond to a patient who has been assessed as high risk. When a patient falls in hospital as a direct result of a nursing or clinical failure below the required standard, and suffers injury — a hip fracture, a head injury, a worsening of their underlying condition — a clinical negligence claim may be available.
When is a hospital fall negligent?
Not every hospital fall is negligence. Patients in hospital are often unwell, medicated, confused, or physically compromised — factors that increase fall risk regardless of the care provided. A fall is potentially negligent where:
- The patient was assessed as high falls risk, and appropriate preventive measures were not put in place
- No falls risk assessment was performed when one was required
- Equipment intended to prevent falls — bed rails, bed sensors, non-slip footwear, nurse call bells — was not provided or was removed
- A patient assessed as requiring supervised mobilisation was left unattended
- A patient with known confusion or delirium was not adequately supervised
- A patient's medication (particularly sedatives, hypnotics, antihypertensives) was not reviewed for falls risk contributions
- A patient who had already fallen was not re-assessed or placed on additional observation
Falls risk assessment — the required standard
NHS hospitals are required to carry out standardised falls risk assessments on all adult inpatients. Tools used include the MORSE Fall Scale and the St Thomas's Risk Assessment Tool (STRATIFY). NICE guidance (CG161 — Falls in Older People) provides a framework for falls prevention in hospital.
A patient identified as high risk must have a documented falls prevention care plan — including bed positioning, appropriate footwear, environmental modification, and supervision level.
Common injuries from hospital falls
- Hip fracture — especially in elderly patients. A hip fracture in a frail patient can be life-threatening, requiring surgery and prolonged rehabilitation. In some patients it triggers a rapid decline.
- Head injury — including subdural haematoma in patients on anticoagulants
- Wrist fracture
- Shoulder injury
- Wound dehiscence in post-operative patients
- Psychological harm — loss of confidence, fear of falling, depression
Falls in care homes and community hospitals
The same principles apply to falls in care homes and community hospital settings. Where the care provider failed to assess and manage falls risk to the required standard and harm resulted, a claim may be available against the care home or community NHS provider.
SCRIPT 63 — Hospital Infection Claims
Frequently asked questions
Can I claim if my elderly parent fell in hospital and broke their hip?
Yes — if the fall was caused by a failure to assess falls risk, implement appropriate precautions, or supervise a high-risk patient adequately.
Can I claim if a patient fell while trying to reach the toilet because no-one responded to their call bell?
Yes — if the delay in responding to a call bell from a high-risk patient fell below the required nursing standard and caused the fall.
What if the hospital claims the patient got up without calling for help?
Where a patient was assessed as a fall risk and was not supposed to mobilise without assistance, the hospital may still be liable if the care plan was not communicated adequately, the patient's call bell was out of reach, or supervision was inadequate.