Falls are a leading cause of injury-related hospitalisation among older adults in Australia.

While not all falls can be prevented, many can, and the consequences of inaction are significant.

For older people, a fall can mark the loss of independence and reduced quality of life. For health and aged care systems, falls impose a substantial and growing burden, contributing to avoidable emergency presentations, hospital admissions, rehabilitation demand and premature entry into residential aged care.

Despite the impact of falls, Australia lacks a comprehensive strategy for falls prevention and state efforts are often fragmented. A 2023 national policy review found that no Australian jurisdiction had implemented a coordinated, cross-sector falls prevention strategy despite the growing burden and Without action, as the population ages, the health, social and economic costs of falls will continue to rise.

Falls Prevention Alliance Australia, pre-budget submission for 2026–27

We know what works — the challenge is implementing and scaling it

The evidence for falls prevention is well established. Multiple interventions are supported by high-quality evidence and endorsed in national and international guidelines, including ongoing balance and strength exercise, home safety interventions, medication reviews and vision and podiatry care.

Effective prevention depends on identifying individual risk factors and providing coordinated, tailored interventions across community, primary care, hospital and aged care settings. For example, community-based falls prevention programs have been shown to reduce hospitalisations, improve quality of life and independence and are likely to be cost-effective.

The policy challenge is no longer identifying effective interventions, but ensuring they are implemented consistently, equitably and at scale. Some communities have access to well-established prevention programs, while others have little or no support. Access often depends on geography, funding arrangements or local service capacity, exacerbating inequities for people living in rural and remote areas, socioeconomically disadvantaged communities and other underserved populations. As a result, those who may be at greatest risk of poor health outcomes often face the greatest barriers to accessing evidence-based falls prevention services.

Fragmented efforts will not solve a systemic problem

In 2022, the NSW Clinical Excellence Commission convened experts from across sectors to examine the future of falls prevention in the state. The resulting 2023 White Paper, Fall Prevention in NSW: A Call to Action, concluded that effective interventions would remain fragmented and underdelivered without a coordinated state-wide strategy.

Falls prevention is inherently cross-sectoral, requiring coordinated action across healthcare, aged care, community services, housing, transport and local government. Without a shared strategy, prevention efforts risk duplicating efforts in some areas and creating service gaps in others, limiting access to evidence-based programs and reducing their overall impact on the population. As such, the White Paper called for a whole-of-government approach to align services, strengthen data infrastructure, scale evidence-based interventions and embed prevention within existing health and aged care systems.

Similarly, the Australian and New Zealand Falls Prevention Society, together with researchers, clinicians, policymakers and consumer organisations, have highlighted the need for stronger investment and system-level coordination.

This momentum culminated in the formation of the Falls Prevention Alliance Australia in 2025, a coalition of more than 50 academic, professional and consumer organisations advocating for evidence-based, system-wide reform. The Alliance’s pre-budget submission for 2026–27 identified three national priorities:

1. Establish a national falls prevention action plan with cross-portfolio accountability.
2. Deliver a national public awareness campaign to reframe falls as preventable rather than inevitable.
3. Fund prevention pathways across Medicare, aged care and community settings.

Together, these signals from across research, policy and practice reflect growing national recognition that falls prevention is overdue for a coordinated policy response.

NSW has an opportunity to lead

NSW is not starting from scratch. Falls prevention programs already exist across the state, including strength and balance classes, home hazard assessments, multidisciplinary clinical services and community-based prevention initiatives.

NSW is also building practical tools to support better decision-making. Researchers and policymakers are collaborating on system dynamics models using NSW data to test prevention scenarios, identify implementation priorities and better understand long-term system impacts. These tools can support more coordinated and evidence-informed planning across health and aged care systems.

Collectively, these foundations position NSW to move from isolated programs to a coordinated approach to falls prevention. However, existing programs vary in availability, integration and evaluation across the state, meaning that many older Australians do not consistently access evidence-based falls prevention. A state-wide Falls Prevention Strategy could:

• establish clear leadership and accountability across sectors;
• improve coordination between health, aged care, and community services;
• expand access to evidence-based prevention programs;
• strengthen data, monitoring and evaluation systems; and
• ensure equitable access by supporting implementation in underserved communities.

NSW has the evidence, capability and partnerships needed to lead nationally on falls prevention. What is needed now is coordinated government leadership to translate evidence into a state-wide strategy that strengthens accountability, improves coordination and expands access to effective falls prevention. The foundations are already in place; the opportunity is to bring them together into a coordinated system that prevents avoidable harm, supports healthy ageing, increases equitable access and reduces pressure on health and aged care services.

The authors would like to acknowledge Lauren Cameron from Falls Prevention Alliance Australia for developing the infographic included in this article.

Dr Marina Pinheiro is a Senior Research Fellow at the Institute for Musculoskeletal Health and a member of the Policy & Advocacy Working Group of the Falls Prevention Alliance Australia.

Prof Cathie Sherrington is a Professor at the Institute for Musculoskeletal Health and co-chair of the Falls Prevention Alliance Australia Steering Committee.

Dr Louise Pearce is a Postdoctoral Research Fellow at the Institute for Musculoskeletal Health.

iStock photo ID:1159146385