Ealing is London’s falls capital, and it is getting worse
Official NHS data ranks all 32 London boroughs by fall and hip fracture hospital admissions in the over-65s. Ealing records the capital’s highest falls rate at 65 plus and at 80 plus, and its rate has risen since 2019/20 while England’s has fallen.
Published July 2026 by Clearcut Physiotherapy · Data: OHID Public Health Outcomes Framework, 2024/25 · Full method below
Falls admissions per 100,000 over-65s in Ealing, the highest rate of any London borough.
An over-65 in Ealing is more than twice as likely to be hospitalised by a fall as one in Enfield, London’s lowest-rate borough.
Ealing, Hillingdon, Brent and Kensington & Chelsea all rose since 2019/20 while England’s rate fell by 298 per 100,000.
Over-80s in Ealing hospitalised by a fall in a single year, a rate of 6,659 per 100,000.
“One stumble can turn into a fear of walking, and that fear costs an older person their health faster than the fall itself did.”Hassan Mohamoud, HCPC, MCSP · Director, Clearcut Physiotherapy
The falls map of London
Darker red means a heavier falls burden. Each borough’s colour reflects its overall ranking across five measures: how often over-65s end up in hospital after a fall, hip fracture admissions, falls among the over-80s, how many residents are over 65, and how fast that group is growing. Hover over any borough to see its numbers.
* Hackney includes the City of London, which is not published separately in the source data.
The full index, all 32 boroughs
Figures show emergency hospital admissions per 100,000 people aged 65 and over in 2024/25, adjusted so boroughs with older populations can be compared fairly. Rank 1 carries the heaviest falls burden. Click any column heading to sort.
| Rank▲ | Borough | Falls 65+ | Hip fracture 65+ | Falls 80+ | % aged 65+ | 5-yr 65+ growth |
|---|
Reference rates, 2024/25: London 2,045 falls and 468 hip fractures per 100,000; England 1,958 and 536. Hackney includes the City of London, which is not published separately. Source: OHID Fingertips, indicators 22401, 41401 and 22403.
How the ranking works
We measure five things for every borough: how often over-65s end up in hospital after a fall, how often they end up in hospital with a broken hip, how often over-80s end up in hospital after a fall, what share of the borough’s residents are over 65, and how fast that group has grown in the last five years. The first three come from official NHS admissions data. The last two come from official population counts.
The comparison is made fair before anything is ranked. A borough full of 85-year-olds would always look worse than a young borough if you compared raw numbers, so the hospital figures are adjusted for the age mix of each borough. After that adjustment, a high number means falls genuinely happen more often there, not just that more older people live there.
Each borough then gets a position from 1 to 32 on each of the five measures, where position 1 is the worst. We average the five positions to get a score. A borough ranking 1st, 2nd, 4th, 6th and 25th scores 7.6, and a lower score means a heavier burden. The borough with the lowest average score ranks 1st overall. That is Ealing. The highest ranks 32nd, the lightest burden. That is Barking and Dagenham.
Four boroughs are defying the national decline
England’s falls admission rate in the over-65s fell by 298 per 100,000 between 2019/20 and 2024/25. These four boroughs went the other way.
“The injury is often the same in both cases. The wait is what makes recovery harder.”Hassan Mohamoud
Why a fall is never just a fall
Behind every admission in this index is a recovery that shapes whether someone keeps their independence.
Hip fracture patients never return to their former level of independence, and a third leave their own home for long-term care, according to the Office for Health Improvement and Disparities.
The estimated annual cost to the NHS in England of unaddressed fall hazards in the home, according to UK government falls prevention guidance.
“Telling a GP or a physiotherapist is not admitting decline. It is the single thing most likely to prevent the next one.”Hassan Mohamoud
The weeks after a fall decide a lot
“One patient arrived needing two carers just to stand. We rebuilt the basics, sit-to-stands, balance, stepping. In time she walked outside on her own. Confidence mattered as much as strength.”Hassan Mohamoud
The 10-point home fall-risk check
Worried about a parent or an older relative living at home? Walk through their home with this list. It draws on national falls-prevention guidance and takes ten minutes.
“Lift the loose rugs, then walk the bed-to-bathroom route in the dark and fix what you find.”Hassan Mohamoud
- Loose rugs, mats and trailing cables.A rug that slides or a cable across a walking route is one of the most common trip hazards at home. Securing or moving them takes a few minutes and makes every trip through the house safer.
- Good lighting on the stairs and the night-time route.Our eyes need more light as we get older. A clearly lit path from the bed to the bathroom, without hunting for switches in the dark, makes night-time trips far safer.
- Handrails on both sides of the stairs.Rails help most when they are secure, run the full length of the stairs, and are actually used. Adding a second rail is a small change that brings real steadiness.
- Grab rails and non-slip surfaces in the bathroom.Wet, smooth surfaces make the bathroom one of the riskiest rooms in the house. Rails by the bath, shower and toilet offer support exactly where it is needed most.
- Footwear that fits well and grips.Backless or loose slippers can slip off mid-step. Shoes and slippers with a secure fit and a grippy sole give much surer footing, indoors and out.
- Everyday items within easy reach.If the teabags or the saucepans need a chair or a stepladder to reach, it may be worth moving them. Keeping daily essentials at waist height removes a climbing risk entirely.
- A regular medicines review.Taking four or more medicines a day, or any that cause dizziness, can affect balance. A GP or pharmacist will happily review them, and it is always worth asking.
- An up-to-date eye test.Vision changes gradually and often goes unnoticed. An eye test every two years helps make sure steps, kerbs and edges are seen clearly.
- Comfortable strength and balance.Needing to push on the chair arms to stand, or holding furniture to cross a room, is a gentle sign that strength and balance could use some support. Simple, regular exercises can rebuild both.
- A fall or a near-miss in the past year.A previous fall is the strongest sign that another may follow. It is nothing to be embarrassed about, and mentioning it to a GP or physiotherapist opens the door to the right support.
If several of these apply, talk to a GP, pharmacist or a chartered physiotherapist about a falls assessment. Strength and balance programmes, and practical changes at home, measurably reduce risk. This checklist is general guidance, not a clinical assessment.
Rebuilding strength and balance, at home
Clearcut Physiotherapy provides fall prevention rehab, elderly physiotherapy and home-visit physiotherapy across London.
Method and sources
Admissions data: OHID Fingertips (Public Health Outcomes Framework), indicator 22401 (PHOF 2.24i, emergency hospital admissions due to falls, 65+), indicator 41401 (PHOF 4.14i, hip fractures, 65+), and indicator 22403 (falls, 80+). All rates are directly age-standardised per 100,000, persons, at local authority geography, 2019/20 to 2024/25. Data pulled 13 July 2026.
Population data: ONS mid-year population estimates, mid-2024, with five-year growth comparing the 65+ population mid-2019 to mid-2024.
The City of London is not published separately for these indicators; its admissions and population are combined with Hackney. The index therefore covers 32 areas: 31 boroughs plus Hackney including the City of London. Boroughs are ranked 1 to 32 on each of five metrics (falls rate 65+, hip fracture rate 65+, falls rate 80+, % aged 65+, five-year 65+ growth); the composite rank is the unweighted average of the five, where rank 1 is the heaviest burden. Rates in 2020/21 and 2021/22 reflect pandemic-era admission patterns. Rates are age-standardised, so borough age structure is already controlled for in the rate columns; the population columns capture exposure, not risk.
Independence and cost context: OHID indicator commentary and UK government falls prevention guidance.
This index is published by Clearcut Physiotherapy for public information. It reports official admissions data and makes no claims about individual risk or treatment outcomes. Journalists are welcome to reproduce the table, map and figures with a link to this page as the source.
