The Royal College of Physicians | Falls and Fragility Fracture Audit Programme
The National Hip Fracture Database
Part of the Falls and Fragility Fracture Audit Programme
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Annual report 2017

Hip fracture care still improving, but two in five patients still not receiving best practice care

The ninth annual report from The National Hip Fracture Database (NHFD) shows that while more patients are receiving early surgery and surviving a hip fracture, two in five patients are not receiving all of the recommended elements of a hip fracture programme that represent ‘best practice’. Some of the other key findings of the report include:

• Hospital stay increase by one day in English hospitals, equivalent to 160 inpatient beds across NHSe services.
• Over 85% of patients now receive appropriate surgery, but almost 4,000 eligible patients not offered a Total Hip Replacement as recommended by NICE.
• Of 18,141 patients contacted, 9% remain completely immobile four months after their injury.

The elements of care that define best practice in England are designed to encourage teams to deliver key elements of a hip fracture programme – a multidisciplinary, patient-centred approach that considers the wider health of frail people with this potentially life-changing injury. If 40% of patients are not receiving this care – usually because they miss out on just one or two elements, this could compromise their rehabilitation and recovery. If this figure could be halved then a typical unit seeing 360 cases a year would attract an additional £100,000 in BPT each year – an obvious target in financially challenging times. Antony Johansen, geriatrician clinical lead for the NHFD

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