Falls

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • No emergency indicators identified; routine prioritisation applies
    • Refer to local HealthPathways or local guidelines
    • A history of falls in the past year is the single most important risk factor for falls and is a predictor for further falls.
    • Older people reporting a fall or considered at risk of falling should be observed for balance and gait deficits.  They should be considered for interventions that improve strength and balance.
    • Consider referral to clinical pharmacist for Home Medical Review if evidence of polypharmacy.
    • Consider referral to specialist falls clinic (if available) if patient has suffered multiple falls with no cause found.
    • Depending on specialist availability, patients with falls can be referred to either general medicine or geriatric medicine.  In the setting of multiple geriatric syndromes, referral to geriatric medicine may be preferred.
    • Evidence for fall prevention strategies:
      • exercise
      • high dose vitamin D
      • medication withdrawal (particularly antidepressants, antipsychotics and benzodiazepines)
      • occupational therapy home visit
      • restricted multifocal spectacle use
      • expedited cataract surgery (where required)
      • podiatry assessment and intervention
      • multifactorial assessment with targeted interventions (including referral to physiotherapist, occupational therapist and/or dietitian as appropriate).

    Clinician Resources

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Two or more falls in the previous month
Category 2
(appointment within 90 calendar days)
  • Two or more falls in previous 12 months
  • Falls as part of an overall decline in physical, social or psychological function
Category 3
(appointment within 365 calendar days)
  • No category 3 criteria

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Relevant medical history, comorbidities and medications (including an assessment of adherence)
  • Number of falls in the previous 12 months
  • Assessment of cognitive function (MMSE or other validated tool) in patients ≥ 65 years of age
  • Chronological profile of the impact of symptoms on ability to function
  • FBC & ELFTs
  • MSU M/C/S
  • Bone mineral densitometry report, vitamin D assay (if performed)
  • Results of any therapeutic drug monitoring performed within three months of referral

3. Additional referral information Useful for processing the referral

  • Existing psychosocial issues and supports (family, carers, home services, etc)
  • Copies of discharge summaries and outpatient letters relating to hospitalisations for falls, or visits to fall clinics, or home assessments for falls risk, if available
  • Home Medicines Review report if available
  • Nutritional status

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 28 January 2025

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