Aim The aim of this study was to examine the prevalence and nature of fall prevention activities carried out by London primary and secondary care NHS services and targeted at adults aged 65 years or older, as well as the rationale for those activities where they existed.

Method A quantitative approach was adopted–a non-experimental, descriptive, fixed study design combining a review of the literature with the results of a purposive survey of all 143 London NHS services.

Results Despite high levels of fall-related mortality and morbidity, almost two thirds of London NHS organisations lack fall prevention strategies. Where they do exist, none meet the demands of the National Service Framework for Older People (DoH 2001). Most initiatives are small scale, lack significant multidisciplinary input and focus on extrinsic fall causation factors.

Conclusion Compliance with the National Service Framework for Older People will challenge the NHS in London. Resources must be made available for training, equipment and environmental modification. Addressing intrinsic fall causation factors demands the involvement of medical and paramedical personnel to a greater degree than presently occurs.