Primary care trusts should consider commissioning specialist falls services to improve the care of their patients, the national falls audit suggests.
The first national audit to investigate care for falls has found that most local health services provide an inadequate service.
The audit, commissioned by the Healthcare Commission and carried out by the Royal College Of Physicians' Clinical Effectiveness and Evaluation Unit, reveals significant variation in care across PCTs in England, Northern Ireland and Wales.
Results from 157 trusts found that three months after sustaining a fracture, only a fifth of patients were offered an appropriate treatment for osteporosis.
In only one in ten cases did patient's notes document that they had been given information on how to prevent future falls.
For those patients who attended a primary care falls clinic, falls and fracture risk assessments were better.
The audit says that specialist services such as fall clinics could improve the care of their patients.
It recommends that PCTs review the range of therapeutic exercise options available locally and promote evidence-based programmes in collaboration with local authorities.
PCTs should also, they say, look at commissioning community or hospital based clinics that perform the range of risk factor assessments necessary to offer an individual targeted treatment plan to reduce falls and fractures.
Ivan Lewis, health minister, said: "We commissioned this report because we recognise that preventing and responding effectively to falls is a crucial element in ensuring older people's health and wellbeing.
"The report's findings underline the importance of the need for the NHS to improve its focus on tackling this issue.
"In accepting the need for improvement, it is important to acknowledge the significant advances made in recent years."