Falls and Fragility Fracture Audit Programme (FFFAP)

The Falls and Fragility Fracture Audit Programme (FFFAP) is a national clinical audit run by the Royal College of Physicians (RCP) designed to audit the care that patients with fragility fractures and inpatient falls receive in hospital and to facilitate quality improvement initiatives.

What we are doing

Elements of the programme

The FFFAP is comprised of the following four workstreams:

  • National Hip Fracture Database (NHFD) - The NHFD collects data on all patients admitted to hospital with hip fractures and improves their care through auditing which is fed back to hospitals through targeted reports.
  • Fracture Liaison Service Database (FLS-DB) - The FLS-DB aims to evaluate patterns of assessment and treatment for osteoporosis and falls across primary and secondary care.
  • National Audit of Inpatient Falls (NAIF) - This audit evaluates both falls prevention activity prior to the hip fracture and post-falls care, within acute, community and mental health care.
  • The Patient Panel - a group of 9 patient and carer volunteers who support the Falls and Fragility Fractures Audit Programme (FFFAP).

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Who's involved


The programme has been commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and currently covers England and Wales only. 

The audit programme is led by the Royal College of Physicians (RCP), working closely with a broad range of organisations including: 

FFFAP is supported by a board, advisory groups and a patient panel.  

What we have produced

The first report of the new continuous National Audit of Inpatient Falls (NAIF) provides a detailed look into the care and management of patients who sustain a hip fracture a

Although the NHS is no longer organised around regional health authorities, clinical networks, deaneries and training rotation are still regionally based.

This brief report has been designed to summarise information about falls and fragility fracture care across Wales and help people to understand the care provided in their local area. Featuring interactive maps, the report allows for Welsh healthcare units to view their participation and results in the audits so far. 

The Falls and Fragility Fracture Audit Programme (FFFAP) has data available for healthcare professionals and academic institutions to access for research and analysis purposes. 

The National Hip Fracture Database (NHFD) annual report 2018 shows dramatic results of an innovative programme of screening for delirium which has been the focus of attention and investment through NHS England’s best practice tariff.

Falls prevention in hospital: a guide for patients, their families and carers has been designed to help prevent serious injury and unnecessary cost to the NHS caused by older people tripping or falling when they are in hospital.

After the success of our first Improving Falls Care event in November 2014, FFFAP held a second event in Birmingham during June 2015.

The Fracture Liaison Service Database (FLS-DB) facilities audit: FLS breakpoint: opportunities for improving patient care following a fragility fracture audit report provides the first detailed mapping of current service provision for secondary fracture prevention within the NHS in England and Wales.
Data processing statements for the Falls and Fragility Fracture Audit Programme (FFFAP).