Elderly psychiatric patients are at constant risk of having a fall due to numerous reasons e.g. frailty, gait problem, vision problem, cognitive and judgment impairment, psychotropic medications.

Consequences of a fall for an elderly patient could be potentially life threatening, protracted, painful and detrimental. Also the cost of falls for NHS is enormous.

To improve the quality of fall reviews undertaken by junior doctors in Oxford Health Foundation Trust.

The quality of a random sample of 23 fall reviews by junior doctors was assessed against the national guideline (NICE guideline No.: CG21).

Proper actions taken to raise the awareness of junior doctors i.e. circulating an email and short talk about national standards.

The second cycle (Sample size: 17) in 6 months time showed substantial improvement in most areas but not all of them.

In the next stage a “Fall intervention proforma” designed for the wards. Also reminding posters were mounted in clinical rooms and junior doctors’ offices.

The third cycle (Sample size: 10) in 6 months time conducted to assess the sustainability of improvements in our compliance.

Our compliance improved from less than 50% in most essential components of a high quality fall review (Musculoskeletal examination, Neurological examination, History taking, Cardiovascular examination, Medication review) to around 100% in 3rd cycle.

• – routine use of “Fall intervention proforma” as standard check list on the wards

• – mounting of reminding posters in clinical rooms

• – a short talk about fall reviews in induction programme for new junior doctors