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


  • National Hip Fracture Database (NHFD). Continuous data collection. Latest national report published.
  • Fracture Liaison Service Database (FLS-DB). Feasibility study. Data collection 1 June - 30 September 2013. Report due early 2015.
  • National Audit of Inpatient Falls. Data collection May 2015. Reporting September 2015.

Commissioned by the Healthcare Quality Improvement Partnership (HQIP) and delivered by the RCP, FFFAP has four overarching aims:

  1. To improve outcomes and efficiency of care after hip fracture. 
  2. To improve services in acute and primary care to respond to first fracture and prevent second fracture.
  3. To improve early intervention to restore independence.
  4. To work in partnership to prevent frailty, preserve bone health and prevent accidents in older people.

The care that patients receive is measured through a number of elements that run in parallel within the programme.  

Elements of the programme

The audit is comprised of the following three 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.  

For more information visit the NHFD website.


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

This audit measures compliance against national standards of best practice in reducing risk of falls within acute care.


Contact the FFFAP team

020 3075 1619

Key stakeholders 



Improving Falls Care event 20 November 2014

On 20 November 2014 the FFFAP programme held a joint event with the launch of the CareFall e-learning tool. The day featured sessions on the three FFFAP workstreams and the launch of CareFall, an e-learning tool for junior doctors on the prevention and management of falls in hospital. The presentations from the day are below.

For further information about CareFall please email

Last updated on: 31 March 2015

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