Long Lies: Mixed methods study to understand the scale, impact and care trajectory for patients who have a long lie after a fall.

DC0017

When a person is unable to get up off the floor for a prolonged period of time after a fall, this is referred to as a ‘long lie’. Around 1 in 3 adults over 65 have at least one fall a year and around one in 5 of these will be a long lie (over 1 hour). People who have a long lie may suffer a number of complications, including dehydration, pressure injuries, muscle and tissue damage and psychological harm. Longer ambulance response times due to growing pressure on ambulance services means that people are being left on the floor for increasing periods of time. The problem of long lies may therefore be leading to worse health outcomes for an increasing number of people. Whilst there has been a lot of research to understand how to prevent people falling, there is currently little information about how to manage people once they have fallen. Existing advice given to patients who have fallen assumes that an ambulance will arrive quickly. It is also based around concerns that the patient may have a hip fracture and need surgery. However, most people who fall do not have a fractured hip, and current advice that people should not be moved or should restrict fluids may be more dangerous for people who have a long lie. We wish to understand more about what happens when people have a long lie and how people can be helped whilst waiting for an ambulance. We will work with patients and the public as well as relevant health and social care organisations.

We will do this using 7 different research activities:

1. Characterise the frequency and duration of long lies in ambulance patients using data from one UK region held within the CUREd+ routine linked dataset;
2. Understand the care trajectory, health outcomes, and health resource use of patients after a long lie using the CUREd+ linked dataset;
3. Understand the mechanisms by which a long lie impacts care trajectories using hospital notes review for a subset of 200 patients identified from ambulance service data;
4. Identify interventions used to mitigate the impact of long lies before arrival at hospital using a survey of ambulance services and social care providers;
5. Understand how key stakeholders mitigate long lies using staff interviews;
6. Understand the impact of long lies on patient and carers using interviews with patient and carers;
7. Refine the definition of a long lie that is likely to cause harm and identify actions to reduce their consequences for patients.

24 June 2025

In progress

People who have a long lie may suffer a number of complications, including dehydration, pressure injuries, muscle and tissue damage and psychological harm. Longer ambulance response times due to growing pressure on ambulance services means that people are being left on the floor for increasing periods of time. The problem of long lies may therefore be leading to worse health outcomes for an increasing number of people. We wish to understand more about what happens when people have a long lie and how people can be helped whilst waiting for an ambulance. We will work with patients and the public as well as relevant health and social care organisations. Ultimately we aim to refine the definition of a long lie that is likely to cause harm and identify actions to reduce their consequences for patients.

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Yorkshire and Humber Secure Data Environment