According to Estonian Minister of Social Affairs Karmen Joller, changes to the organisation of the Police and Border Guard Board’s work in assisting people who have fallen at home must not result in people being left without help or in such calls being automatically transferred to the ambulance service.
Naturally, the ambulance service responds to emergencies involving health concerns. However, it is important that information about repeated falls is also passed from the Emergency Response Centre to the local government. This enables the local government to provide the person with more sustainable support in a timely manner, preventing their need for assistance from escalating and thereby avoiding repeated emergency calls.
According to Joller, a situation must be avoided in which the police withdrawing from responding to falls effectively means transferring these calls to the ambulance service.
We cannot solve the workload of one emergency service by simply placing it on another. Health-related emergencies must be handled by the ambulance service, but if a person primarily needs help getting back on their feet, or if repeated falls are caused by an underlying need for social support, we need to find another solution
Karmen Joller, Estonian Minister of Social Affairs.
The Ministry of Social Affairs has been working together with the Ministry of the Interior and local governments to find such a solution. Joller added that she would have preferred the solution to be in place before the Ministry of the Interior decided to withdraw from responding to these calls. “The problem of falls is serious and cannot simply be passed from one institution to another like Pontu in Kuulsuse narrid; instead, we need to work together to find a systemic and effective solution,” Joller added.
“The role of the Emergency Response Centre is to determine whether a person may have a health problem requiring urgent attention. If so, the ambulance service will naturally respond. However, there are various causes behind falls. Statistics show that only 7% of fall-related calls required the ambulance service alone, while an ambulance was involved alongside the police or rescue services in approximately 24% of cases. This means that in at least 76% of cases, medical attention was not required. Yet every such call can mean that an ambulance crew is unavailable at the same time to respond to a person suffering a stroke or heart attack, someone with severe trauma, a young child with a high fever, or anyone else whose life and health depend on rapid medical assistance,” said Minister of Social Affairs Karmen Joller.
“Since many falls are linked to social circumstances where the local government can provide assistance, a key priority is ensuring that information is passed on to the local government. This has also been the main point of discussion with the Ministry of the Interior, which oversees the Emergency Response Centre,” Minister Joller emphasised.
The high number of repeated falls demonstrates that one-off assistance is not enough. Information about a person who has fallen repeatedly should reach the local government from the police, rescue services or ambulance crew that attended the scene, or directly from the Emergency Response Centre. This enables the local government to contact the person and their relatives and explore appropriate solutions — whether that involves support from neighbours or the wider community, home-based services, assistive devices or other necessary assistance. The person’s own willingness to accept help, as well as arrangements with relatives and neighbours, are also important.
According to Joller, preventing falls and organising assistance for people who fall at home cannot be considered solely the responsibility of emergency services. The individual, their relatives, the community and the local government all have a role to play. However, a local government can only provide support if information about the person’s need for assistance reaches it.
“We need to pay attention to our relatives and neighbours and maintain our relationships with them. If an elderly person or someone living alone falls repeatedly, we need to understand why this is happening and what we can do to prevent it from happening again,” said Joller. “The attentiveness of relatives and the community cannot be replaced by any emergency service,” the minister added.
According to the Ministry of Social Affairs, the solution must be based on three principles: emergency calls made through 112 should continue to be handled according to the person’s actual need for assistance and the health risk involved; information about repeated incidents or cases where the need for assistance is increasing must be systematically communicated to the local government; and the local government can arrange support for the person that helps prevent further falls.
The ambulance service must, above all, remain available for people whose health requires urgent medical intervention.
In 2025, 898 incidents involving people falling at home were registered in Estonia, accounting for only 0.2% of all incidents reported by the Emergency Response Centre to emergency services. In 454 cases, only the police responded. In a further 161 cases, the police responded together with the ambulance or rescue services. The ambulance service alone was dispatched to 63 incidents, accounting for 7% of all registered cases of people falling at home.
As of 1 September, the Police and Border Guard Board does not plan to respond to calls where a person who has fallen at home needs help getting back on their feet and there is no danger requiring police intervention. Until now, the police have responded to such calls under an agreement concluded between the Emergency Response Centre and the Police and Border Guard Board in 2016.
An analysis by the Ministry of Social Affairs shows that the number of falls at home varies significantly between local governments. In 83% of local governments, there was less than one such incident per month, while ten local governments recorded no such incidents at all throughout 2025.
In Tallinn, 280 incidents were recorded, accounting for nearly one-third of all cases — an average of 23.3 incidents per month. In Pärnu, Narva and Tartu, there were an average of 5.8 incidents per month. Tallinn was the only local government where more than ten incidents were recorded per month.
Therefore, the Ministry of Social Affairs does not consider it reasonable to establish a new nationwide 24/7 “social emergency service” system. Establishing such capacity in every local government would cost an estimated €37.3 million per year, while a regional model would cost at least €7.2 million per year.
A fall may be a sign of a greater need for assistance
The analysis shows that 39% of fall-related incidents originated from addresses where incidents had occurred repeatedly. In total, there were 120 such addresses, from which an average of nearly three reports were received during the year.
According to the Ministry of Social Affairs, this indicates that some calls are not the result of an isolated accident but rather reflect a person’s ongoing or increasing need for assistance. Simply helping someone back on their feet does not solve this underlying problem.
At present, information about such incidents does not systematically reach local governments. Of the local governments that responded to a survey conducted by the Ministry of Social Affairs, 28 said that they do not receive information about incidents involving people falling at home.
Information from the Emergency Response Centre and emergency services must reach local governments so that a social worker can assess why a person is falling repeatedly and what kind of assistance they actually need. This could include adapting the home environment, providing an assistive device, an emergency alarm with a response service, home-based services or other forms of support.
Source
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