Too many elderly people are suffering preventable falls.

Barry Nelson hears a common-sense call for changes which could reduce the grim toll of death and injury and save the NHS some much needed cash.

ELDERLY people who fall and hurt themselves spend a lot of time telling doctors that it wasn't their fault. According to the seven women and six men who make up the Newcastle Citizen's Jury they may have a very good point. The jury, invited to choose a pressing issue to investigate as part of a research project funded by the Rowntree Foundation, opted for the subject of falls and the elderly.

Virtually all of the mixed bag of office workers, nurses, retired people and managers who made up the panel knew an elderly relative who had suffered as a result of having a fall. A common feeling among the jury members is that not enough is done to prevent these potentially devastating events. They also felt that the NHS and care homes were not geared up to meet the needs of elderly people once they had had a fall.

Falls are the commonest reason for older people to attend accident and emergency departments in the UK, accounting for up to 45 per cent of all of all older patients. Every year 35 per cent of adults over 65 and 45 per cent of those over 80 suffer at least once, with ten per cent of incidents resulting in a fracture. Experts believe that falls may be the single most influential trigger resulting in able-bodied older persons becoming infirm.

The over-prescription of sedatives seems to be a big problem. In the US, measures to reduce sedative prescriptions have led to a massive decline in the number of falls in nursing homes.

Recruitment of potential jurors began when the Policy, Ethics and Life Sciences (PEALS) Research Institute at the International Centre for Life sent out invitations to 1,500 people chosen at random from the electoral role in Newcastle. Around 60 potential jurors attended the first meeting.

Gradually this figure was whittled down to 13 who opted to hear evidence on the question: "How can new health technologies be designed and regulated such that the lives of older people are improved, not merely lengthened, particularly in relation to falls?"

The jury members met six times during October and November last year to hear expert evidence. For many of the jury members this was the first time they had been involved in anything like this.

Butcher Philip Callaghan, 51, says: "I was very apprehensive when I went to the first meeting, I had never met any of the others but we all got on well, we helped each other."

When the witnesses began giving their evidence, the jury was firm about bringing them down to earth. "We told the speakers if they used any jargon, they had to stop," says Philip.

One of the most influential witnesses was Professor Rose Anne Kenny of Newcastle University, who runs the pioneering "faints and falls" unit at the Royal Victoria Infirmary. She told the jury members the unit could completely cure one in seven elderly people referred to the unit with falling problems and reduce the number of subsequent falls by 30 per cent.

Set up in 1991 to provide older patients with rapid access to hospital treatment after falling, it is the only unit of its kind in the UK.

Casualty doctors can refer the patients to the unit, where they are seen with a week.

A study by Newcastle University researchers published last September demonstrated that the unit has provided enormous savings for the NHS - equivalent to freeing up a whole ward for a year.

On Wednesday this week the jury members presented their verdict to a gathering of health and social care professionals, charitable organisations and drug company representatives.

The jury's wide-ranging recommendations, if implemented, would undoubtedly cost the NHS a fortune. But the jury argues that it would be money well spent, freeing up hospital beds and allowing large numbers of otherwise disabled people to live a fuller, more independent life.

The main recommendation is that every hospital should set up a multi-disciplinary falls unit to co-ordinate and improve the care given to older people who are prone to falls.

This should provide a "seamless service", from the person's fall to recovery, for those thought to be prone to falls (such as those with early dementia, diabetes, osteoporosis or starting new treatment to lower blood pressure); those who have already experienced their first fall and those who have already repeatedly fallen.

For those who have already fallen there should be active intervention to reduce the risk of further falls at home and in their daily routine. For those who are repeatedly falling, more radical intervention might be needed.

The jury would like the service to include hospital doctors, physiotherapists, GPs, nurses, home help, social services and community groups doing accident prevention work.

In the concluding statement the jury acknowledges that their reforms would be costly but they argue it would be cheaper in the long-term because it would keep more people out of hospital, freeing up beds.

So what will happen to this worthy report. Will it simply gather dust somewhere?

Not if Tom Wakeford, PEALS project co-ordinator, has anything to do with it. "The head of the Department of Health public involvement unit has taken a keen interest in what we are doing and we are certainly hoping it will influence future policy," says Dr Wakeford.

"It is important for the NHS to see the value of ordinary people getting involved in developing policy rather than just accepting what is handed down," he adds.

The bottom line is that better funding for healthcare services for the elderly should be a Government priority, says Dr Wakeford.

* A copy of the final report is available at www.peals.ncl.ac.uk/publications/DIYFinalVerdict.pdf