A Royal College of Physicians programme that has contributed to improving post-operative care of elderly people who suffer a hip fracture is celebrating its 10-year anniversary.
The National Hip Fracture Database (NHFD) has collected data continuously on all patients in England, Wales and Northern Ireland aged 60 and over with a hip fracture since 2007. During this time more than half a million patient records have been submitted, enabling comprehensive monitoring of patient care from admission to hospital through to post-discharge follow-up.
Reporting on NHFD data has contributed to major improvements in patient treatment and care, including*:
- The number of hospitals participating in the NHFD has increased from 11 in 2007 to 177 in 2017.
- The rate of early surgery has increased from 54.5% in 2007 to 71.5% in 2011.
- A reduction in 30-day mortality after hip fracture – from 10.9% in 2007 to 7.1% in 2016.
- An increase in the number of patients receiving bone-strengthening medication – from 66% in 2011 to 80% today.
To celebrate the 10-year anniversary, the NHFD programme is holding a stakeholder event at the British Medical Association on Tuesday 21 March. The day will focus on sharing learning from the data and the successful work of medical teams in improving patient care.
NHFD clinical leads Mr Rob Wakeman and Dr Antony Johansen will be speaking at the event, alongside Professor Chris Moran, the national clinical director for trauma at NHS England.
Mr Rob Wakeman, NHFD clinical lead, orthopaedic surgery, said:
Since its inception in 2007, the NHFD has overseen major innovations in collaborative working between orthopaedic surgeons and geriatricians in hospitals. These advances have enormously improved the outcomes for older patients with hip fracture injury.
Despite improvements, this devastating and often life-changing injury still remains a major challenge. We now have a very clear idea of what good hospital care looks like for hip fracture patients but good community and post-discharge physiotherapy support is also vital to optimise recovery. It is also the best way of minimising extra pressure on social care resources that can result from reduced independence when an older person suffers a hip fracture in a fall.
For more information about the programme, including audit reports, visit the NHFD website.
* Data sourced from the NHFD audit reports 2007–16
Key facts from the NHFD Audit
- Hip fracture is common, with 65,000 such injuries each year across England, Wales and Northern Ireland (NHFD 2015).
- For older people (60+), hip fracture is the commonest serious injury; the commonest reason for them to need emergency anaesthesia and surgery; and the commonest cause of accidental death (NHFD 2016).
- Patients may remain in hospital for a number of weeks, leading to one and a half million bed days being used each year, which equates with the continuous occupation of over 4,000 NHS beds a year (NHFD 2016).
- Hip fracture patients face a significant risk of dying or of losing their independence, and prognosis is dependent on how well hospital and community services work together (NHFD 2015).
- Hip fracture is associated with a total cost to health and social care services of over £1 billion per year, which equates to about 1% of the total NHS budget (NHFD 2016).
About the National Hip Fracture Database (NHFD)
The National Hip Fracture Database (NHFD) documents major innovations in collaborative working between orthopaedic surgeons and geriatricians which drive improved care for patients requiring emergency hip fracture surgery. Its annual report collates this data.
The NHFD is a clinically-led, web-based quality improvement initiative commissioned by the Healthcare Quality Improvement Partnership (HQIP) and managed by the Royal College of Physicians (RCP). The NHFD was founded by the British Orthopaedic Association and the British Geriatrics Society between 2004 and 2007. It has collected data since 2007. The first audit report from the data was published in 2009.
In 2012 the NHFD moved to be managed as part of the Falls and Fragility Fracture Audit Programme (FFFAP) within RCP London.
About HQIP, the National Clinical Audit Programme and how it is funded
The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP holds the contract to manage and develop the National Clinical Audit Programme, comprising more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions. The programme is funded by NHS England, the Welsh Government and, with some individual audits, also funded by the Health Department of the Scottish Government, DHSSPS Northern Ireland and the Channel Islands.