Falls and acute mobility assessment (Multifactorial falls risk and acute mobility assessment)
A thorough medical assessment to find out why someone is falling or struggling to move safely, and to plan ways to lower the risk.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A falls assessment looks for the specific, often treatable reasons behind falls — it rarely finds just one cause.
- It cannot promise you will never fall again, but a good plan can meaningfully lower your risk.
- Expect a plan on the day for some things, with a few test results following over days to weeks.
- A serious fall — head injury, suspected fracture, confusion, weakness or chest pain — is a 999 emergency, not a planned assessment.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Identifies the specific, often treatable reasons you are falling
A planned assessment is the wrong route during an acute emergency such as a head injury, suspected fracture, stroke symptoms or chest pain — these need...
You answer detailed questions and do simple physical tests. You can rest if you feel tired or lightheaded, and the assessor stays close during balance and...
A clear, written, personalised plan covering exercise, medicines and home safety.
You answer detailed questions and do simple physical tests. You can rest if you feel tired or lightheaded, and the...
You usually leave with an initial plan: possible medication changes, exercise or physiotherapy advice, home-safety...
Results of blood tests, ECG, bone-health assessment or monitoring come back, and your plan may be adjusted...
You work on strength and balance exercises, settle into any medicine changes, and make home and footwear changes.
What is a falls and acute mobility assessment?
A falls and acute mobility assessment is a structured medical review to work out why someone is falling, feeling unsteady or finding it harder to move about safely. Rather than blaming 'old age', it looks for the specific, often treatable reasons behind falls.
Falls usually have more than one cause at once — for example, blood pressure that drops on standing, certain medicines, poor balance or strength, eyesight problems, foot or footwear issues, or a new illness. Because of this, a good assessment is 'multifactorial': it checks several areas and then targets the ones that matter for you.
If a fall has caused a serious injury, a bang to the head, or if someone cannot get up, is confused, has chest pain, weakness on one side, slurred speech or a suspected broken bone, that is an emergency — call 999. A planned falls assessment is for people who are stable but at risk, not for a medical emergency happening now.
This guide explains what the assessment involves, what it can and cannot do, and how to get the most from it. It does not replace personal medical advice.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
History and falls story
A detailed account of when, where and how you fall, any warning symptoms, dizziness, blackouts, and how falls are affecting your confidence and daily life.
Medication review
A look at all your medicines, including ones that lower blood pressure, cause drowsiness or affect balance, to see if any can be reduced, changed or stopped safely.
Heart and blood pressure checks
Lying and standing blood pressure (to spot drops on standing), pulse, and sometimes an ECG heart tracing to look for rhythm or blackout causes.
Strength, balance and gait
Watching you stand, walk and turn, and simple timed tests to measure balance, leg strength and walking, often guiding referral to physiotherapy.
Preparing for your test
- Bring an up-to-date list of all your medicines, including anything bought over the counter, and recent dose changes.
- Write down when and how your falls happen, any warning signs, and whether you blacked out.
- Bring your glasses, hearing aids and the footwear you usually wear.
- Bring any walking aid you use, even if you only use it sometimes.
- Note any recent illness, new symptoms, dizziness, or changes in continence.
- If possible, bring someone who has seen you fall, as their account is valuable.
- Wear or bring clothing that lets you walk and move easily during the assessment.
What happens
The clinician starts by asking in detail about your falls: when they happen, what you were doing, any warning symptoms such as dizziness, lightheadedness or blackouts, and how falls are affecting your confidence and independence.
They examine you, including lying and standing blood pressure, your heart, and often a check of vision, feet, strength, balance and the way you walk. Simple timed tests of standing up and walking are common. They review every medicine you take, looking for any that increase falls risk.
Depending on what they find, they may arrange tests such as blood tests, an ECG, a bone-health (fracture risk) assessment or, occasionally, heart-rhythm monitoring or imaging. They will usually talk through an initial plan with you on the day — for example medication changes, physiotherapy for strength and balance, vision or foot care, home-safety changes, or bone-protection treatment — and arrange any onward referrals and follow-up.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- A planned assessment is the wrong route during an acute emergency such as a head injury, suspected fracture, stroke symptoms or chest pain — these need 999.
- It will not help if the real problem is a single untreated condition needing urgent specialist care, such as a serious heart-rhythm disorder, which should be referred promptly.
- It is of limited value if you cannot or will not engage with exercises, medicine changes or home-safety steps afterwards.
- It is not a substitute for urgent assessment of recurrent unexplained blackouts, which may need cardiac investigation.
Delay or rearrange if…
- You are acutely unwell, feverish or have a new infection — be seen for that first.
- You have an unstable new symptom such as chest pain, severe breathlessness or new weakness.
- You have just had surgery or a hospital stay and are not yet stable enough to take part.
- Key information is missing, such as your medicines list or an account of how you fall.
Alternatives to discuss
- NHS GP, falls clinic or community falls team assessment.
- Physiotherapy-led strength and balance programmes such as community falls-prevention classes.
- Occupational therapy home-safety assessment.
- Cardiology referral if blackouts suggest a heart cause.
- Watchful waiting with simple home-safety changes if falls are very occasional and minor.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Identifies the specific, often treatable reasons you are falling
- Can reduce how often you fall and the chance of a serious injury
- Reviews medicines that may be adding to the problem
- Picks up related issues such as low bone density, low blood pressure or heart-rhythm problems
- Supports confidence, independence and staying active safely
- Connects you with physiotherapy, occupational therapy and other helpful services
Risks & complications
- Tiredness during balance, walking and strength tests
- Feeling lightheaded during standing blood pressure checks
- Finding it upsetting to talk about falls and loss of confidence
- Needing further tests or appointments before the full picture is clear
- A near-fall during physical testing, which the assessor will guard against
- Anxiety if an underlying problem such as a heart or bone issue is found
- Uncertainty when no single clear cause is identified
- Discovering a serious underlying condition that needs urgent treatment
- Side effects or symptom changes when medicines are adjusted, needing review
A falls assessment is low-risk in itself; the main limitation is that it cannot guarantee you will not fall again, and sometimes no single cause stands out. The most important things to discuss are which of your medicines might be contributing, whether your blood pressure drops on standing, your bone-health risk if you were to fall, and a realistic plan to build strength and balance. Tell the clinician about any blackouts, as these may need separate heart investigations.
Published figures to discuss
How much a falls assessment reduces future falls depends heavily on the person, their causes and how fully the plan is followed. Strength and balance exercise programmes and structured multifactorial interventions have the best evidence for reducing falls, but published figures vary widely between studies and settings. Because of this variation, reputable guidance focuses on tailoring the plan to the individual rather than quoting a single success rate.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Fracture or head injury missed | Higher with pain, deformity, anticoagulants or frailty | Inability to weight-bear, hip pain, head strike or confusion needs urgent assessment. | NICE NG249 — Falls: assessment and preventionnice.org.ukSource-linked context |
| Underlying acute illness missed | Common in older adults | Infection, dehydration, arrhythmia, stroke, medication toxicity or delirium can present as a fall. | NICE NG249 — Falls: assessment and preventionnice.org.ukSource-linked context |
| Recurrent falls | Common without multifactorial assessment | NICE falls guidance emphasises strength/balance, vision, medicines, feet, hazards and bone health. | NICE NG249 — Falls: assessment and preventionnice.org.ukSource-linked context |
| Loss of confidence and mobility | Common after a fall | Fear of falling can reduce activity and increase future risk if not addressed. | NICE NG249 — Falls: assessment and preventionnice.org.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from the assessment itself. 'Afterwards' is about acting on the plan: starting exercises, adjusting medicines, making home changes and attending any follow-up tests or appointments.
- Feeling tired after the physical tests
- Brief lightheadedness during standing blood pressure checks
- Waiting a little while for some test results
- Taking time to adjust to new exercises or medicine changes
- Mixed feelings — relief at having a plan, but worry about falling
Aftercare
- Start and keep up any strength and balance exercises you are given — these are among the most effective steps.
- Follow advice on medicine changes and report any new symptoms after adjustments.
- Make recommended home-safety changes, such as removing trip hazards and improving lighting.
- Wear well-fitting, supportive footwear and use any walking aid as advised.
- Keep eyesight, hearing and foot care up to date.
- Take any bone-protection treatment as prescribed if your fracture risk is raised.
- Attend follow-up and any onward appointments, and know who to contact if falls worsen.
- Your full medicines list, including recent changes
- Notes on when and how you fall, and any warning signs
- Glasses, hearing aids and usual footwear
- Any walking aid you use
- Contact details for the falls service or your GP
- A way to record future falls and near-falls
- Someone who can help with home-safety changes
⚠ Get urgent help if…
- A fall with a head injury, a suspected broken bone, or being unable to get up — call 999
- New confusion, weakness on one side, facial droop or slurred speech — call 999, this could be a stroke
- Chest pain, severe breathlessness, or fainting and blacking out — seek emergency help
- A fall while taking blood-thinning medicine, especially after a head injury — seek urgent advice
- Repeated blackouts or falls with no warning
- A sudden worsening in walking, balance or alertness
- Severe dizziness, vomiting or a severe headache after a fall
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good outcome is a clear understanding of the main reasons you are falling and a practical, personalised plan to reduce your risk — for example fewer falls-related medicines, better blood-pressure control, stronger balance, safer footwear and a safer home. You usually get the start of this plan on the day.
An assessment cannot prove you will never fall again, and a normal set of results does not rule out future falls. Its real value is lowering your risk and helping you stay active and confident, while flagging anything that needs separate treatment such as a heart-rhythm problem or low bone density.
Falls risk changes over time as health, medicines and circumstances change, so a plan made now may need revisiting — especially after an illness, a hospital stay, a new diagnosis or a medicine change. Keeping up strength and balance exercises tends to give the most durable benefit, and many people benefit from periodic reassessment.
Related tests, treatments or support
A falls assessment often runs alongside related checks, such as a bone-health (fracture risk) assessment, a heart-rhythm review if blackouts occur, a medication review, and physiotherapy or occupational therapy. Treating low bone density at the same time can reduce the chance that a future fall causes a fracture.
Follow-up & long-term care
Follow-up depends on what is found. You may be reviewed by your GP, a falls clinic or a community team to check progress, see how medicine changes are working, and review any test results. Physiotherapy and occupational therapy often involve several sessions. Tell your team if falls become more frequent or severe.
- Keep doing strength and balance exercises regularly, not just for a few weeks.
- Have medicines reviewed periodically, especially if new ones are added.
- Keep eye tests, hearing checks and foot care up to date.
- Maintain home-safety changes and replace worn footwear.
- Continue any bone-protection treatment and review it as advised.
- Ask for reassessment after any illness, hospital stay or new fall pattern.
Repeat, follow-on and what comes next
- Plans are often adjusted as test results come back or as medicine changes take effect.
- Reassessment is normal after an illness, hospital stay, new fall pattern or change in medicines.
- Some causes only become clear after monitoring, so a first assessment may lead to further tests.
- Ongoing exercise and review matter more than a single one-off assessment.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear, written, personalised plan covering exercise, medicines and home safety.
- A named contact and a route to report new or worsening falls.
- Arranged physiotherapy or occupational therapy where needed.
- Follow-up to check progress and review medicine changes and test results.
- Onward referral for any heart, bone or specialist issues identified.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The length and depth of the assessment, and whether a consultant geriatrician or a specialist team carries it out.
- Which tests are included, such as blood tests, ECG, bone-health (DEXA) assessment or heart-rhythm monitoring.
- Whether physiotherapy and occupational therapy input or a home visit is part of the package.
- The complexity of your medicines and other health conditions.
- Follow-up appointments, written reports and any onward referrals.
- Any equipment or aids recommended after the assessment.
- The clinician's fee and how long the assessment will last.
- Which tests are included and which are charged separately.
- Whether physiotherapy, occupational therapy or a home visit is included.
- Whether a written plan, letter and onward referrals are provided.
- Follow-up arrangements and the cost of further appointments.
- What happens if a serious problem is found and needs urgent care.
On the NHS? Falls and mobility assessments are commonly available on the NHS when clinically indicated; private assessment may be used for faster access, choice or a second opinion.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being told that the assessment lowers, but cannot remove, falls risk.
- Medicine changes made without a clear plan to review their effects.
- Blackouts not being recognised as needing separate heart investigation.
- No written plan or clear route to report worsening falls.
- Fracture (bone-health) risk not being discussed when relevant.
Marketing red flags
- Claims that a single test or device will 'stop falls'.
- Selling equipment or supplements without a proper multifactorial assessment.
- Promising to fix balance in one session.
- Downplaying the need to review medicines or investigate blackouts.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What do you think are the main reasons I am falling?
- Are any of my medicines adding to my falls risk, and can they be changed?
- Does my blood pressure drop when I stand, and what can help?
- What is my risk of breaking a bone if I fall, and should I have treatment?
- Which exercises or physiotherapy will help my strength and balance most?
- What home changes would make the biggest difference for me?
- When should I be reassessed, and who do I contact if falls get worse?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can I get a falls assessment on the NHS?
Will the assessment stop me falling?
Why are my medicines being reviewed?
What is the lying and standing blood pressure test for?
What if no clear cause is found?
I had a serious fall — should I book an assessment?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NICE NG249 — Falls: assessment and prevention NICE QS86 — Falls in older people quality standard NHS — Falls NHS — Falls: prevention
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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