Councils are commissioning falls prevention services built around strength and balance exercise, while housing and care providers invest in technology and training. This guide explains what is being commissioned, what FaME is, how the three approaches fit together and what a good specification covers. It is written for commissioners, and for housing and care providers who want to work with them.
Key points
- Falls prevention services are built around structured strength and balance exercise, such as FaME.
- Recent council notices add healthy ageing, early intervention and referral routes around the exercise core.
- Exercise reduces risk, technology detects and records, training helps staff respond and learn.
- Specify the programme, instructor competence, referral routes and outcome measures.
- Housing and care providers hold falls data that commissioned services rarely see.
What is a falls prevention service?
A falls prevention service is a commissioned programme that reduces the risk of older people falling, instead of only responding once someone is on the floor. Most combine structured strength and balance exercise with assessment, advice and referral into other support. They are usually commissioned by councils or the NHS and delivered in community venues and people’s homes.
What are councils commissioning now?
Two recent notices show the shape of current commissioning. We cite them as public evidence of demand. Altus is not named in either.
West Sussex County Council has held market engagement for a Falls Prevention Service delivering evidence-based FaME programmes for older adults aged 65 and over at risk of falling, aligned with NICE recommendations.
London Borough of Ealing has published a notice for a borough-wide Healthy Ageing and Falls Prevention service for residents aged 50 and over. It has three parts: community strength and balance, healthy ageing and early intervention, and navigation and referral.
The pattern is exercise at the core, with earlier intervention and clear routes between services around it.
What is FaME?
FaME stands for Falls Management Exercise. It is a 24-week programme for people aged 65 and over that combines group-based strength and balance sessions with individual assessment. It is delivered by a specially trained instructor and is designed to improve strength and balance and reduce the risk of falls. Commissioners name it in specifications because it is a defined, structured programme, which makes it possible to check whether what is delivered matches what was bought.
The national clinical reference is NICE guideline NG249, Falls: assessment and prevention in older people and in people 50 and over at higher risk. A specification should point providers to the current guideline and ask how their programme follows it.
How do exercise, technology and training fit together?
These are three different tools. They are sometimes bought as if they were alternatives. They work best together.
| What it does | What it does not do | Typical buyer | |
|---|---|---|---|
| Strength and balance exercise | Reduces a person’s risk of falling by improving strength, balance and confidence | Help in the moment when someone does fall | Council public health, NHS |
| Technology | Detects a possible fall, raises an alert and records when and where incidents happen | Prevent the fall itself | Housing providers, adult social care, care providers |
| Training | Helps staff recognise risk, respond well to a fall and learn from each incident | Replace clinical assessment or exercise | Care providers, housing with care |
A person leaving a falls exercise programme may still live alone. A falls detector or personal alarm covers the time when nobody is there. In housing with care and in care homes, staff who understand falls risk make better use of both. Our telecare equipment buyer’s guide explains what falls detectors can and cannot do, and the technology enabled care page sets out the wider picture.
What should a falls prevention service specification include?
- Who it is for. Age range, risk criteria and how people living with frailty or long-term conditions are included.
- Referral routes. Who can refer, whether people can refer themselves, and how quickly someone is seen.
- The programme. Which structured programme is delivered, for how long, and how it is tailored and progressed for each person.
- Instructor competence. The qualifications required and how quality is checked.
- Access. Venues, transport, home-based options and provision for people who do not speak English as a first language.
- Links to other services. Home hazard checks, medication review, sight and hearing, housing adaptations and telecare.
- What happens afterwards. How people keep active when the programme ends.
- Data. What is recorded, how outcomes are measured and how results are reported to the commissioner.
How do you measure whether a falls prevention service is working?
Attendance is the easy measure and the least useful on its own. Ask for completion as well as starts, change in strength and balance measured the same way at the beginning and end, falls reported by participants during and after the programme, and whether people are still active some months later. Agree the measures before the contract starts, so the baseline is collected from the first participant.
Where the people supported live in schemes or care settings that already record falls, use that data too. Patterns by time of day, location and activity often show where a practical change would help. Our fall prevention page explains how we approach that in care settings.
Where do housing providers and care providers fit?
A council-commissioned exercise service reaches people in the community. Housing providers and care providers hold the other half of the picture: they know who has fallen, they manage the buildings, and their staff are often first to respond. Commissioners get more from a falls service when the specification asks providers to work with local housing and care organisations on referrals, venues and shared learning.
For housing and care providers, the practical steps are to know your own falls data, make sure alarm and warden call equipment will still work after the digital switchover, covered in our guide to digital warden call systems, and give staff the training to act on what they see.
How can Altus help?
We do not deliver exercise programmes. We work alongside the providers who do. For care and housing organisations we offer a half-day falls review, free and without obligation, in person or remote. You bring your falls data. We establish a baseline of falls and behaviours, work out whether technology or training is the right path, and give you a written report with actionable steps. We also provide CPD-accredited care training.
Falls prevention commissioning checklist
- Is the target group defined by age and risk, with a clear referral route?
- Does the specification name a structured programme and its duration?
- Are instructor qualifications and quality checks set out?
- Can people who cannot travel take part?
- Are links to home hazard checks, medication review and telecare described?
- Is there a plan for keeping people active after the programme?
- Are outcome measures agreed, with a baseline from the first participant?
- Are local housing and care providers involved in referrals and shared learning?
Frequently asked questions
What is a falls prevention service?
A falls prevention service is a commissioned programme that reduces older people’s risk of falling. Most combine structured strength and balance exercise with assessment, advice and referral to other support. They are usually commissioned by councils or the NHS and delivered in community venues and in people’s own homes.
What is the FaME exercise programme?
FaME stands for Falls Management Exercise. It is a 24-week programme for people aged 65 and over that combines group-based strength and balance sessions with individual assessment. It is delivered by a specially trained instructor and is designed to improve strength and balance and reduce the risk of falls.
Does falls technology prevent falls?
Not by itself. A falls detector or sensor reports that a fall may have happened and summons help, and the records show when and where incidents occur. Prevention comes from exercise, assessment, a safer environment and staff acting on that information. Technology supports those measures. It does not replace them.
Who commissions falls prevention services?
Councils and the NHS commission most community falls prevention services, often through public health teams. Recent examples include West Sussex County Council, for FaME programmes for people aged 65 and over, and the London Borough of Ealing, for a healthy ageing and falls prevention service for residents aged 50 and over.
How do you measure the success of a falls prevention programme?
Measure more than attendance. Useful measures are the proportion of people who complete the programme, change in strength and balance assessed the same way at start and finish, falls reported during and after the programme, and whether participants are still active months later. Agree the measures before the contract starts.
If you run care or housing services and want a clear view of your own falls picture, bring your data and we will review it with you. Book a half-day falls review.