National Hip Fracture Database

November 2016

General Practitioners

Country of origin: UK

It is estimated that there are 70,000 hip fractures a year in the UK[1] and this is only set to increase as the population gets older. The latest National Hip Fracture Database (NHFD) report, from the British Orthopaedic Association (BOA), the British Geriatrics Society (BGS) and the RCP, finds that care for patients with hip fracture is improving. 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.

The National Hip Fracture Database national report 2013, commissioned by the Healthcare Quality Improvement Partnership (HQIP), details that the quality of care patients receive and the timeliness in which they undergo surgery for hip fracture are getting better. It also indicates that, 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 report, published today, shows that:

• 86% of patients receive surgery within 48 hours
• 3.5% of patients are reported to have developed pressure ulcers
• 49% 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 4 hours is down slightly from 52% in 2012 to 50% in 2013.

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).

The NHFD is a collaboration between the BOA and the BGS and is managed by the RCP and commissioned by HQIP. It aims to improve the quality and effectiveness of hip fracture care by enabling clinical teams to monitor their performance against agreed clinical standards from the BOA and BGS. The NHFD also monitors compliance with the NICE Guidance 124 - ‘The Management of Hip Fracture in Adults’.

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