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

Reported by the Royal College of Physicians London (14 September 2017): The National Hip Fracture Database's (NHFD's) ninth annual report shows that while more patients are receiving early surgery and surviving a hip fracture, two in five are not receiving all of the recommended elements of a hip fracture programme that represent ‘best practice’.

Key findings

The NHFD report analyses the process and outcomes of care of nearly 65,000 people who presented with a hip fracture across 177 hospitals. It reports much good practice within inpatient care, with the majority of patients getting prompt surgery, specialist geriatric assessment and consideration of their nutritional status.

But, across the country nearly 40% of patients are still not receiving the full package of care that represents best practice and are missing out on important clinical assessments that will improve their rehabilitation and recovery after this serious injury. In addition, in England, the full package attracts the £1,335 additional payment of Best Practice Tariff (BPT), so hospitals are missing out on potential income.

Some of the other key findings of the latest report include:

  • A rise in length of hospital stays of 1 day in English hospitals, equivalent to the use of an extra 160 inpatient beds across NHS services in England.
  • Over 85% of patients now receive surgery appropriate to the type of their hip fracture, but almost 4,000 patients that NICE recommend should be offered a Total Hip Replacement were not able to have that operation.
  • An examination of patient outcomes at 120 days shows that from the 18,141 patients for whom the audit has this data, 9% (1,545) remain completely immobile 4 months after their injury.

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