Mixed methods study to understand the scale, impact and care trajectory for patients who have a long lie after a fall
Specialty: Trauma and Emergency Care, Primary sub-specialty: Pre-hospital; Health Category: Disputed Aetiology and Other
Current methodology as of 12/11/2025: This observational mixed-methods study will investigate the experiences and outcomes of adults who have fallen and were unable to get up from the floor for an extended period – a ‘long lie’. Participants will be identified through linked ambulance, emergency department, and hospital records, with all personal information removed prior to analysis. Quantitative analyses will describe who is affected, the duration spent on the floor, associated health complications, and patterns of healthcare use over the following 12 months. Health and social care costs will also be estimated, and detailed hospital record reviews will be conducted for a subset of 200 patients to examine clinical outcomes. To understand current practice, interviews will be undertaken with professionals from ambulance, hospital, and residential or care home settings to explore how people are supported after a fall and while waiting for help. A further group of interviews will be conducted with people who have experienced being unable to get up after a fall, and with their relatives or carers, to explore personal experiences and the impact on daily life. Findings from both the quantitative and qualitative components will be discussed in a national workshop with key stakeholders from health and social care services. This will inform the development of clear, evidence-based guidance to support people who have fallen and are awaiting assistance. Previous methodology: The team is conducting a mixed methods study comprising seven interrelated work packages (WP1-WP7). A brief overview of the entire project is provided below. Ethics approval from the University of Sheffield (UOS) has been obtained for WP4 and WP5, but Health Research Authority (HRA) approval is also required. Additionally, a subsequent HRA and NHS ethics application will be submitted for WP3 and WP6. WP1: This work package aims to understand the characteristics and care trajectory of ambulance service
Current inclusion criteria as of 12/11/2025: WP3: Patients must have fallen, been unable to get up off the floor, and consequently called 999 for an ambulance. They must also have been transported (conveyed) to one of the four participating study hospitals within the Yorkshire and Humber region. WP4a: UK NHS 999 Emergency Operations Centre ambulance service clinical leads. WP4b: Residential and nursing home managers, and Home care Workers in the UK. WP4c: Those working in residential and nursing homes, providing home care support, and in other providers of social care. WP5: Health professionals involved in the management of individuals that are unable to get up from the floor for a long time after a fall, working in three ambulance service areas – South West, East Midlands and Yorkshire and Humber. Seeking individuals in a variety of organisations and roles such as Urgent Community Response (UCR); Frailty or falls services (community and acute settings), emergency departments, other relevant roles. WP6: Individuals (and their carers) who have fallen and been unable to get up off the floor for a long period of time, and help was contacted. Previous inclusion criteria: WP4 - UK NHS 999 Emergency Operations Centre ambulance service clinical leads (n=13) WP4b) residential and nursing home managers in the Yorkshire area (using the 18+ Wakefield Research Hub networked research-active residential homes) WP4c) UK-wide care and residential home managers WP5 n = 22-26. Key stakeholders across 3 ambulance service areas - a variety of roles in the ambulance service including frontline clinicians and 999 call handlers. Hospitals within the participating ambulance will identify staff that are involved throughout the process of care such as ED, frailty and acute medicine departments (dependent upon the findings from WP1). Residential and care home staff in the participating ambulance service areas.
Current exclusion criteria as of 12/11/2025: WP3: Registration with NHS Data Opt-out, or if they have already been approached to participate in the study. WP5: Health professionals working in the healthcare field who are not directly involved in the management of this patient cohort and does not work within the three specific geographical boundaries. Previous exclusion criteria: Not meeting the participant inclusion criteria