Simple safety measures to prevent frail, elderly patients from falling are receiving "scant attention" in some hospitals, a new audit has concluded.
Hospitals have "considerable room for improvement" in preventing falls among patients, according to the National Audit of Inpatient Falls.
There were around quarter of a million falls in NHS hospitals in England in 2015/16, according to NHS Improvement data published in July.
These resulted in more than 2,500 hip fractures, distress for patients and their families and, for some, a slower recovery from the illness that saw them admitted to hospital in the first place.
Now the latest audit, by the Royal College of Physicians, has highlighted that some hospitals are not undertaking basic steps to prevent a patient's risk of falls - the majority of which occur among patients over the age of 65.
For instance, 28% of patients who needed access to a walking aid could not reach it.
And almost one in five patients (19%) could not reach their call bell, according to the audit.
"The highly variable rates for patients having easy access to the call bell suggests that this simple safety measure is receiving scant attention in some hospitals," the authors wrote. "We recommend a hospital-wide approach to address this."
Meanwhile, all patients who need walking aids should have access to them "from the time of admission, 24/7", they added.
The authors said that while falls cannot be entirely prevented there are some steps that hospitals can take to reduce a patient's risk.
And if hospitals adhere to best practice guidance, around 20 to 30% of falls could be prevented.
Researchers gathered data from 97% of hospital trusts and health boards in England and Wales.
They found that the rate of some methods for preventing falls showed improvements between the 2015 audit and the 2017 audit - such as blood pressure measurements, delirium assessments and mobility aids being in reach, which rose from 68% in 2015 to 72% in 2017.
But the authors added: "However, these rates leave considerable room for improvement in most trusts."
They found no significant improvements in other key measures including; having a continence care plan in place, patients undergoing a vision assessment, patients having a call bell in reach and whether or not they had been assessed for medications that increase falls risk.
The authors added: "There was substantial variation in levels of assessments and interventions between hospitals; more than can be explained reasonably by variations in case mix or the range of good clinical practice."
Dr Shelagh O'Riordan, clinical lead for the audit, said: "Our results show that although there are areas of really good care, and significant improvements have been made by some hospitals, many hospitals are still not doing everything they can to prevent falls.
"I hope this audit can help clinical teams work towards reducing the number of falls currently happening in hospitals in England and Wales."