There are wide differences in how UK ambulance services respond to 999 calls from elderly people who have fallen, research suggests.
A survey of 11 out of 13 services found variations in how people were assessed and the number who were transferred to hospital.
Falls are a major cause of injury among older people, with around one in three over-65s failing each year.
Previous research has found that 8 per cent of all 999 calls in London are for older people who have fallen.
In the UK, and internationally, about 40 per cent of older people who fall and dial 999 are not transported to hospital.
The new study, from experts at the Yorkshire Ambulance Service, Health Services Research in Sheffield and Swansea University, found the proportion of patients left at home in the UK varies from 7 per cent to 65 per cent.
All ambulance services had systems in place to transfer 999 calls about elderly falls to telephone-based clinical advisors.
One service had a further system where calls deemed less urgent were referred to falls teams to assess and “pick up” patients. Two other services reported plans for similar schemes.
All the services deployed specially-trained healthcare workers, such as emergency-care practitioners, to respond to calls.
But seven services sent vehicles that were not crewed by emergency technicians or paramedics, while all 11 services said they sent vehicles crewed by just one member of staff.
One service was testing the deployment of non-clinical staff while another had a specialist falls response ambulance, crewed by a paramedic and a social worker.
Referrals to other services were made by paramedics (eight services), emergency medical technicians (seven services) and emergency-care practitioners (nine services).
But referrals were made from various places, with six services making referrals at the scene, three from base stations and eight via the communications room.
Writing in the Emergency Medicine Journal, the authors said: “The key issues identified relate to wide variations in provision of care across services.
“These findings highlight the urgent need for research to inform policy, service and practice development for the large and frail population of older people who have fallen and for whom a 999 call has been made.”
A spokeswoman for the Department of Health said: “There is a duty of care on ambulance trusts to ensure that the response they send to the patient can provide the appropriate level of care.
“Where patients need a paramedic, one should be dispatched.”