Background: in 2007, the National Patient Safety Agency (NPSA) published 'Slips trips and falls in hospital' and 'Using bedrails safely and effectively'.Objectives: this observational study aimed to identify changes in local policies in hospitals in England and Wales following these publications.Method: policies in place during 2006 and 2009 were requested from 50 randomly selected acute hospital trusts and their content was categorised by a single reviewer using defined criteria.Results: thirty-seven trusts responded. Trusts with an inpatient falls prevention policy increased from 65 to 100, the use of unreferenced numerical falls risk assessments reduced from 50 to 19, and trusts with a bedrail policy increased from 49 to 89. It was concerning to find that by 2009 advice on clinical checks after a fall was available in only 51 of trusts, and only 46 of trust policies included specific guidance on avoiding bedrail entrapment gaps.Conclusions: the observed changes in policy content were likely to have been influenced not only by the NPSA publications but also by contemporaneous publications from the Royal College of Physicians' National Audit of Falls and Bone Health, and the Medicines and Healthcare products Regulatory Agency. Most areas of local policy indicated substantial improvement, but further improvements are required.
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