Geriatrics: Care improving for hip fracture patients, report shows

Care for patients with hip fracture is improving with more patients are receiving surgery within 48 hours of admission than in 2012 and almost all patients (94%) are receiving a falls assessment before being discharged from hospital.

These are the findings of the latest National Hip Fracture Database (NHFD) report, from the British Orthopaedic Association (BOA), the British Geriatrics Society (BGS) and the Royal College of Physicians (RCP). 

It shows that:

– 86% of patients receive surgery within 48 hours;

– 3.5% of patients are reported to have developed pressure ulcers;

– 47% of patients are being assessed by an orthogeriatrician;

– 94% receive a falls assessment prior to discharge.

The number of patients being admitted to an orthopaedic ward within four hours is down slightly from 52% in 2012 to 50% in 2013. At any one time, over 4,000 NHS beds in England, Wales and Northern Ireland are occupied by a patient recovering from hip fracture.

The 2013 NHFD report sees the largest number of data records submitted, from the largest number of hospitals and the largest number of patients since the NHFD first began in 2007. This national report profiles the care of over 95% of all cases; 61, 508 cases from 180 hospitals.

In spite of the progressive improvements that the NHFD has documented in this and previous reports, there remains considerable variation in the care being offered in different hospitals. The report describes this in detail, and examines the potential implications of this variation by comparing mortality figures in different hospitals. A number of hospitals with poorer figures are identified and will be offered support in addressing persistent problems.

There is also considerable variation in the length of time that patients spend in hospital recovering from hip fracture. The report highlights that hospitals in England are achieving reduced length of stay with an average of 22 days for hip fracture patients, compared with hospitals in Wales (35 days) and Northern Ireland (33 days).

Dr Kevin Stewart, clinical director, Clinical Effectiveness and Evaluation Unit, RCP said :”The results from the latest NHFD national report are very encouraging, demonstrating that the quality of care for hip fracture patients continues to improve.  Since hip fracture mainly affects frail older patients, it is especially important that we get it right in this vulnerable population. These results have been achieved despite the recent well-publicised pressure on emergency departments. They are a tribute to the national leadership of the British Orthopaedic Association and the British Geriatrics Society and the dedication of the national leadership team and multidisciplinary clinical teams up and down the country.”

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