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State of Wales Report 2020

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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.

Key recommendations

Local health boards should ensure:

  • That they have appointed an orthogeriatrician to lead multidisciplinary care in each trauma unit.
  • Ensure that falls teams responsible for their acute, community and mental health hospitals are signed up to contribute to, and learn from, the National Audit of Inpatient Falls. 
  • Implement an FLS as an urgent priority for sites without one and they should link with the ROS service delivery team.
  • Effectively participate with the FLS-DB to ensure FLSs are meeting their expected outcomes through the KPI.
  • Support the WOAG and other structures to provide the mentorship for FLS-QI. For example, in a population of 300,000, an effective FLS will prevent around 250 fragility fractures.

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. There has been significant improvement in the performance of the hip fracture treatment in Wales since the previous report.