If you or a family member suffered a hospital fall claim in the UK, you can claim compensation where the fall was caused by the hospital's negligence. You must show the trust failed to take reasonable steps to prevent the fall — such as carrying out a proper fall-risk assessment, providing bed rails or supervising a confused patient. Claims against NHS trusts are handled by NHS Resolution. Compensation is valued under the Judicial College Guidelines for the injury sustained, plus special damages for financial losses. The time limit is generally three years.
Patient falls are one of the most commonly reported patient safety incidents in NHS hospitals. NHS England data shows that falls account for a significant proportion of all patient safety incidents reported each year, with hip fractures being the most serious consequence. For elderly patients, a fall in hospital can be catastrophic — turning a routine admission into a life-changing injury or even death. This guide explains when a hospital fall amounts to negligence, how compensation works, and what evidence you need. We are an independent information service, not a law firm.
When is a hospital fall negligent?
Not every fall in hospital is the result of negligence. Patients who are unwell, medicated or confused can fall despite reasonable precautions. The legal test is whether the hospital met the standard of care that a reasonably competent hospital would provide in the circumstances, applying the Bolam test (Bolam v Friern Hospital Management Committee [1957]) as refined by Bolitho v City and Hackney Health Authority [1998].
Common failures that may amount to negligence include:
- Failure to carry out a fall-risk assessment. NICE Clinical Guideline CG161 (Falls in older people: assessing risk and prevention) requires hospitals to assess all inpatients aged 65 and over, and any patient judged to be at elevated risk, on admission. Failure to do so is a well-recognised breach.
- Failure to act on the assessment. Identifying risk without putting a care plan in place (bed rails, low-level beds, non-slip footwear, 1:1 observation for confused patients, sensor mats) is equally a breach.
- Inadequate supervision. A confused patient repeatedly attempting to get out of bed who is left unsupervised, particularly at night.
- Wet or slippery floors. Spillages, cleaning without warning signs, or poorly maintained flooring.
- Medication effects. Prescribing sedatives, opioids or blood-pressure medications without considering and managing the increased fall risk.
- Inadequate mobilisation. Encouraging a patient to mobilise after surgery without adequate physiotherapy support or walking aids.
Common injuries from hospital falls
The injuries caused by a fall in hospital depend on the patient's age, frailty and what they hit. Common injuries include:
| Injury | Significance for compensation |
|---|---|
| Hip fracture (fractured neck of femur) | The most serious common outcome. Often requires surgery (dynamic hip screw or hip replacement), prolonged rehabilitation and may leave permanent mobility restrictions. In elderly patients it carries significant mortality risk. Valued in the higher JCG brackets for hip injuries. |
| Wrist or forearm fracture (Colles' fracture) | Common when the patient puts a hand out to break the fall. Usually treated with a cast; may need surgical fixation. |
| Head injury / subdural haematoma | Particularly dangerous in patients on anticoagulants (blood thinners), which are common among elderly inpatients. Can be fatal or cause permanent brain injury. |
| Spinal fracture | Vertebral compression fractures are common in osteoporotic patients. May cause chronic pain and loss of height. |
| Shoulder fracture or dislocation | Proximal humerus fractures in elderly patients can result in permanent loss of function. |
✓ The eggshell skull rule
A hospital cannot argue that the patient was already frail or had osteoporosis and so "would have broken a bone anyway". Under the eggshell skull (or thin skull) rule in tort law, the defendant takes the claimant as they find them. If a negligent fall caused a hip fracture in an 85-year-old with osteoporosis, the hospital pays for the full extent of that injury.
Compensation for a hospital fall
Compensation has two parts:
- General damages — for pain, suffering and loss of amenity, valued using the Judicial College Guidelines, 17th edition (2024) for the specific injury sustained. A hip fracture, for example, is assessed under JCG Chapter 7(L), with brackets ranging from lower amounts for undisplaced fractures with full recovery to substantial sums where there is permanent disability, need for a hip replacement or loss of independent living.
- Special damages — for financial losses: private treatment or rehabilitation, care costs (professional or gratuitous care provided by family), aids and equipment (walking frames, stair lifts, home adaptations), lost earnings if the patient was still working, and travel expenses. In elderly patients who lose their independence, the cost of residential care or increased home care can be the largest element.
Where a hospital fall leads to death, the estate and dependants can claim under the Fatal Accidents Act 1976, including a statutory bereavement award (currently a fixed sum), loss of dependency and funeral costs. See our fatal accident claims guide.
Evidence you need
| Evidence | How to obtain it |
|---|---|
| Medical records (nursing notes, observation charts, drug charts) | Request under the Data Protection Act 2018 / UK GDPR; the trust must provide them within one month. Your solicitor will obtain these. |
| Fall-risk assessment (or proof it was not done) | Should be in the nursing admission documentation. Its absence is itself evidence of a breach. |
| Incident report / Datix entry | Hospitals are required to record patient safety incidents. Request via the trust's complaints or legal department. |
| CCTV footage | Some ward corridors have CCTV. Request it promptly as retention periods are short (often 30 days). |
| Expert medical report | Your solicitor instructs a consultant (orthopaedic, geriatric medicine or neurosurgery) to report on the injury, the standard of care and causation. |
| Nursing expert report | A nursing expert assesses whether the fall-prevention measures met the required standard. |
| Care and loss reports | If ongoing care is needed, a care expert and forensic accountant quantify the future costs. |
The claims process
Hospital fall claims are clinical negligence claims (sometimes called medical negligence), which follow a more formal process than ordinary personal injury:
- Obtain medical records. Your solicitor requests the full hospital notes, including nursing records, drug charts and any incident report.
- Expert review. Independent medical and nursing experts review the records and advise on whether the standard of care was met and whether the fall caused the injury (causation).
- Letter of notification. Under the Clinical Negligence Pre-Action Protocol, the claimant sends a letter of notification to NHS Resolution, followed by a detailed letter of claim.
- NHS Resolution investigates. The trust has four months to investigate and respond, either admitting or denying breach and/or causation.
- Negotiation or court. Many claims settle after exchange of evidence. If not, court proceedings are issued.
Clinical negligence cases are complex, take longer and cost more than standard PI claims. Most are handled on a no win, no fee basis, but the solicitor must carry ATE (After the Event) insurance to cover the risk of paying the defendant's costs if the claim fails. See our ATE insurance guide.
Time limits
The standard time limit is three years from the date of the fall under the Limitation Act 1980, section 11. However:
- If the patient lacked mental capacity at the time (common in elderly patients with dementia or delirium), there is no time limit while the incapacity continues.
- For children, the three years run from their 18th birthday.
- Where the patient has died, the estate has three years from the date of death (or date of knowledge).
See our claim time limits guide for more detail.
NICE guidelines and the standard of care
NICE Clinical Guideline CG161 (Falls in older people: assessing risk and prevention, updated 2013) is the benchmark against which hospitals are judged. It requires:
- All inpatients aged 65 and over to be assessed for fall risk on admission.
- Any patient with a history of falls, mobility impairment, visual impairment, cognitive impairment or on high-risk medication to be assessed regardless of age.
- A multifactorial care plan addressing the identified risks.
- Appropriate interventions: low beds, bed rails where safe, non-slip footwear, adequate lighting, continence management, medication review and supervised mobilisation.
Failure to follow CG161 is strong (though not conclusive) evidence of a breach of the duty of care.
Getting help
We are not a law firm. We do not take on claims, sell your details or recommend particular firms. To find a regulated solicitor experienced in clinical negligence and hospital falls, use the Solicitors Regulation Authority register and the Law Society "Find a Solicitor" service, filtering for clinical negligence accreditation. Action against Medical Accidents (AvMA) is a charity that provides free advice to victims of medical negligence.
Frequently asked questions
Can I claim compensation for falling in hospital?
Yes, if the fall was caused by the hospital's negligence. You must show the hospital owed you a duty of care, that it breached that duty (for example by failing to carry out a proper fall-risk assessment, not providing bed rails, leaving wet floors unmarked or failing to supervise a confused patient), and that the breach caused your injury. Not every fall in hospital is negligent, but many are preventable.
Who pays compensation for an NHS hospital fall?
NHS Resolution (formerly the NHS Litigation Authority) handles clinical negligence claims against NHS trusts in England. In Scotland it is the Central Legal Office, in Wales the Welsh Risk Pool, and in Northern Ireland the relevant Health and Social Care Trust. The compensation comes from public funds, not from individual doctors or nurses.
How long do I have to claim for a hospital fall?
Three years from the date of the fall, or from the date you first knew the fall was caused by negligence (the date of knowledge rule under the Limitation Act 1980, section 14). For patients who lack mental capacity there is no time limit while the incapacity continues. For children the three years start at their 18th birthday.
What is a fall-risk assessment?
A standardised assessment carried out when a patient is admitted, identifying factors that increase fall risk such as age, mobility problems, medication (especially sedatives, blood pressure drugs or painkillers), confusion, a history of falls and visual impairment. NICE Clinical Guideline CG161 requires hospitals to assess all inpatients aged 65 and over, and any patient judged to be at elevated risk, and to put a care plan in place.
What injuries commonly result from hospital falls?
Hip fractures are the most common serious injury, particularly in elderly patients. Other common injuries include wrist and forearm fractures, head injuries, spinal fractures, shoulder injuries and subdural haematomas. In frail patients a hip fracture can trigger a cascade of complications including pneumonia, blood clots and prolonged immobility, sometimes leading to death.
Is every fall in hospital negligent?
No. Some falls occur despite all reasonable precautions. The question is whether the hospital took the steps a reasonably competent hospital would take in the circumstances. If the trust failed to assess fall risk, ignored a known risk factor, left side rails down when they should have been up, or failed to supervise a confused patient who had already attempted to get out of bed, that is more likely to amount to negligence.
Can I claim if my elderly relative fell in hospital and died?
Yes. If the fall was caused by negligence and contributed to the death, the estate and dependants can bring a claim under the Fatal Accidents Act 1976 and the Law Reform (Miscellaneous Provisions) Act 1934. This can include a bereavement award, loss of dependency and funeral costs. See our fatal accident claims guide for more.
Get help from official, free sources
- Action against Medical Accidents (AvMA) — free advice for medical negligence victims
- Solicitors Regulation Authority (SRA) — check a solicitor is regulated
- The Law Society — Find a Solicitor — clinical negligence accredited
- Citizens Advice — free, impartial guidance
Related guides: medical negligence claims, nursing home negligence claims, hip injury claims, broken bone claims, and fatal accident claims.