Fall prevention for older people in England is failing as overloaded GPs struggle to help those most at risk, MPs have warned.
The House of Commons’ public accounts committee said NHS leaders had accepted that the current position was “not acceptable”.
The cross-party committee found that GPs are doing too little to tackle falls among older people, even though falls are the most common cause of death from injury among over-65s.
Falls also cause tens of thousands of hip fractures, add to hospitals’ workloads and are estimated to cost the UK £4.4bn a year.
The committee said pressure on GPs had intensified after the government’s decision to give patients online access to services.
Professor Victoria Tzortziou Brown, president of the Royal College of GPs, said the report vindicated the college’s warnings that prioritising online access without equal focus on continuity and proactive care may have unintended consequences.
She said: “While most GP practices will always try to offer their older patients the time they need, this is increasingly challenging against a backdrop of intense workloads and workforce pressures while also responding to increasing demand and policy requirements to improve access.”
Family doctors in England are required under their contract to identify, assess and support people over 65 with moderate or severe frailty.
Frailty refers to a reduced ability to recover from illness, injury or physical stress, making people more vulnerable to falls and sudden deterioration.
However, the committee said “many GPs are not currently able to deliver on these requirements”.
During 2024/25, just 17 per cent of patients with moderate or severe frailty were assessed.
Only 18 per cent of the 226,000 people diagnosed with severe frailty that year were assessed for their risk of falling, while 16 per cent had a review of the medication they were taking.
The committee said the situation had arisen because “NHS England has overloaded GPs, who have limited capacity, with new and expanding priorities.
It added: “NHS [England] has prioritised improving patients’ access and digital access to general practice.”
“It recognises that pushing to improve one aspect of care inevitably causes consequences to appear elsewhere, in this case support for people with frailty.”
Almost one in three local NHS areas are assessing fewer than 10 per cent of over-65s for their risk of frailty and falling.
However, nine areas assessed at least 90 per cent of such patients, which MPs said suggested that good performance is possible within existing resources.
NHS England is examining whether other health professionals could take on some frailty-related work that often goes undone.
This could include asking pharmacists to review medicines taken by frail older people.
Polypharmacy, which means taking several medicines at the same time, can increase the risk of falls, as can some specific medicines.
Older people with poor balance, weak muscles, impaired sight and certain medical conditions are also at greater risk of falling.
Caroline Abrahams, charity director at Age UK, said it was almost 10 years since identifying frailty was first made a priority in GP contracts.
She said: “Older people living with frailty are at much higher risk of deterioration following even minor health shocks.”
“Having a serious fall can be devastating and in some cases is essentially terminal, and either way increases pressure on an already overstretched NHS.”