Across the Integrated Care Board (ICS) the long lie pathway is now live. The aim of this pathway is for treatment and assessment to be completed in the community, which will be quicker than going into hospital.

Falls are distressing for all individuals, they can affect dignity, mobility and create a fear of falling, in addition to the complications that can occur due to a long lie.

  • The evidence shows that long lies can increase the risk of pressure sores, even moderate amounts of pressure from bony prominences such as heels or hips on a hard surface can cause pressure sores in a short time.
  • The life-threatening condition rhabdomyolysis in the elderly can be caused which is a condition in which damaged skeletal muscle breaks down rapidly (Henderson, 2015).
  • The risk of developing hypothermia and pneumonia is likely (Age UK, 2013).
  • Increases the probability of future hospital admissions (Gallet et al, 2018).

You can view the long lie pathway here.

Below is a reminder of the steps that should be taken once somebody has been found on the floor.  Once called, the prevention of admission will implement that pathway to prevent a hospital admission after a long lie.

Once somebody has been found on the floor:

  1. Individual has been found on the floor, it is not known how long the individual has been there
  2. Primary survey: Complete initial checks to determine red flags and if a 999 call is needed. If the below is a YES, please call 999.
  • Intense Pain?
  • Suspected Collapse?
  • Trauma – to Head/Neck/Back?
  • Taking blood thinning medication and suspected head trauma or unwitnessed fall?
  • Unusual Behaviour?
  • Marked Difficulty in Breathing/ Chest Pain?
  • Bleeding Freely?
  • Loss of Consciousness?
  • Evidence of Fracture?
  1. Complete FAST test for evidence if a stroke has occurred. If the FAST test isn’t normal, please call 999.
  2. Secondary survey: Complete checks to determine if there are any illnesses or injuries.
  • Bruising
  • Cuts
  • Discomfort
  • Controllable bleeding
  • Suspected fracture or dislocation
  • Skin tear
  • Minor injury and takes anticoagulant medication
  1. Seek further medical advice by contacting the Prevention of Admission services, they will then be able to implement the long lie pathway.


Early Intervention vehicle:

East and North Herts: EIV service

  • 0300 123 7571 option 3, option 2. Please use direct number rather than 111
  • Covers the districts of Broxbourne, East Herts, North Herts, Stevenage, and Welwyn Hatfield.
  • 7 days a week, 8am-8pm


South-West Herts:  Urgent Community Response: EIV service

  • 03000 020 0655 option 2
  • Covers districts of Dacorum, Hertsmere, St Albans, Watford, and Three Rivers
  • 7 Days a week, 8am-6.30pm


For other Admissions Avoidance and Support Services, please watch the webinar HERE