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State of the nation Wales report 2022

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This brief report has been designed to summarise information about falls and fragility fracture care across Wales and examines how inpatient care has changed since 2020, showing what the three audits reveal about the quality of patient care, and the impact of the COVID-19 pandemic.

Key recommendations

The report highlights the following recommendations:

  • Local health boards should ensure that they have appointed an orthogeriatrician and that they actively support their leadership of multidisciplinary care in each trauma unit.
  • Local health boards should ensure that falls teams in acute, community and mental health hospitals are included in quality improvement activities and are using the data from the National Audit of Inpatient Falls.
  • With falls teams reviewing health board level data and implementing focused quality improvement interventions should help improve the quality and safety of care in hospitals.
  • Health boards without an FLS should contact the Royal Osteoporosis Society and use their implementation toolkit to support them in preparing a business case.
  • Health boards that already have an FLS should ensure it is actively participating in the FLS-DB, and meeting its expected outcomes as defined by the FLS-DB’s set of KPIs.

Full report

The Falls and Fragility Fracture Audit Programme is a suite of three national clinical audits: the National Audit of Inpatient Falls (NAIF), the National Hip Fracture Database (NHFD), and the Fracture Liaison Service Database (FLS-DB).

These are commissioned by the Healthcare Quality Improvement Partnership (HQIP), funded by Welsh Government and NHS England, and run by the RCP in collaboration with a range of stakeholders that include a panel of patients/carers.

These audits provide a quality improvement platform for local Health Boards in Wales – aiming to help local clinical teams and health service managers understand why people fall in hospital, the care that should be provided for fragility fractures, and what can and should be done to prevent future fractures.