REMEDY : BNSSG referral pathways


Checked: 27-04-2017 by christopher.moloney Next Review: 27-04-2018

Falls Pathway - Bristol

See the full Falls Care Pathway (word doc) for guidance on the management of falls.

Also see the Integrated Strength and Balance Pathway for Bristol

Community Assessment of Falls - Bristol Community Health

This service is for patients registered with a  Bristol GP and who have already been screened for any unstable medical problems. 

Older people who have had more than one fall in the last 12 months or have difficulty with balance or walking or present for medical attention following a fall will benefit from a multifactorial falls risk assessment ( See Bristol Community Health link below for a downloadable falls risk assessment tool)

The falls specialist nurse provides non-urgent comprehensive geriatric assessment for complex patients at risk of recurrent falls, who are registered with a Bristol GP and who have already been screened for any unstable medical problems. She will then agree an action plan for further investigation or risk reduction with the patient and refer on to other services as necessary.

Please see the Bristol Community Health - Falls in older people website for more information regarding this service.

Referral Guidance - Bristol Community Health

If you are a clinician or GP and you wish to refer a patient to our falls specialist nurse, please send a brief medical summary or letter, via the confidential fax number below or via post to the address listed below. Referrals are not accepted directly from care homes.

Please indicate what you hope to achieve from the assessment and ensure that the routine Falls Blood tests have been completed.

Ruth Cowell, Falls Specialist Nurse
Knowle Clinic,
Broadfield Road,
Bristol BS4 2UH

Tel No: 0117 9190290
Mobile: 07767 220 976
Fax 0117 9190296

Falls Pathway - South Gloucestershire

Refer to the Falls Care Pathway for South Gloucestershire.  See also the Falls Risk Assessment.

Falls and Balance Service - Sirona

Service for adults registered with a GP in the South Gloucestershire area who have been identified as being at an increased risk of falling or who have had unexplained falls or black-outs.

Clinics are held at Cossham or Thornbury hospitals, Yate Health Centre or Patchway. Appointments take at least an hour.

Patients may be offered a short exercise and balance course which are run by our specialist physiotherapy team.

Referral Guidance - Falls and Balance Service

This service is for patients registered with a  South Gloucestershire GP practice.

This service is available by referral through GP referral or referral from another health professional.  Contact the service at:

Sirona Care and Health

Downend Clinic (Locality Office)

Buckingham Gardens,

Downend, Bristol

BS16 5TW​

 or by emailing ​

 Please attach/enclose the completed referral form

Secondary Care Assessment - NBT

The North Bristol Trust Falls Clinic for Older People is designed for patients who have fallen due to suspected syncope, patients with unexplained dizziness or who have recurrent falls where a cause has not been found despite performing a multi-factorial falls risk assessment, or patient is falling despite interventions put in place to manage risks. 

Referrers must first complete a Bristol Community Health Multi-factorial Risk Assessment Form (PDF).

Patients attending will receive a Comprehensive Geriatric Assessment by a consultant or Specialist registrar as well as having a review of bone health. If required, investigations will be arranged with results sent to the patient's GP with advice on further management.


-Patients who require physiotherapy / occupational therapy only.

-Patients who have already had a Hospital Medical Assessment of Falls in the last 24 months.


Please also see here for the Falls Assessment and Onward Referral form.

Referral to this NBT service can be made via E-Referral (General Older Person's Medicine and Falls Specialist Medical Assessment at Southmead or Cossham).

Referral letters or forms can also be faxed to 0117 414 9457.

Secondary Care Assessment - UBHT

UBHT Care of the Elderly Team has two options for patients with falls.

A Falls Service is available at the Day Assessment Unit in South Bristol Community Hospital. This service is provided for patients aged over 60 who have fallen and live within the UH Bristol catchment area. The service is provided by a multi-disciplinary team with specialist knowledge of falls management and includes a consultant, nurses, occupational therapists and physiotherapists with links to hearing and speech and language therapists if required. There is also access to diagnostic tests e.g. x-ray, bloods, ECG, ultrasound.

A Syncope clinic is also available at the BRI. This service is for patients with unexplained falls, dizziness and blackouts (including younger syncopal patients). Please send a letter of referral to Dr MacMahon, at the BRI. Dr MacMahon is also happy to take telephone queries: 0117 3426309.


Staying Steady Classes - Bristol

Staying Steady is a programme of strength and balance classes to help build strength and confidence and lower risk of falling. It forms tier 1 of the integrated strength and balance pathway for Bristol.

There is a small cost for these classes.

Staying Steady classes are for people with: 
        - concerns about falling or avoiding activity due to concern about function/abilities
        - challenges with balance or walking
        - a risk of falling (low to moderate)
- Who are motivated to engage in strength and balance exercise
- Can sit to stand from a chair with or without use of arms AND independently walk around a chair
- Can independently get to a strength & balance class

Further information can be found on the Bristol City Council website.