Hip fracture toolkit

Our hip fracture implementation toolkit has been developed as a product of the REDUCE study: REducing unwarranted variation in the Delivery of high qUality hip fraCture services in England and Wales.

We have worked with the University of Bristol REDUCE study team to develop this evidence-based toolkit to support hospital teams make organisational and management changes to their hip fracture services in order to improve patient outcomes.

The tools are designed to support you and your team to:

  • Ensure effective clinical governance underpins your service
  • Optimise multi-disciplinary team working 
  • Ensure effective clinical pathways are established
  • Recruit the right staff for the service
  • Design high quality services that improve patient outcomes
  • Write business cases to support service improvement
  • Support junior medical staff onto the hip fracture unit 

Whilst this Implementation Toolkit has been informed and designed based on evidence from hip fracture research, many tools are applicable to non-hip fragility fracture services. Similarly, whilst the evidence-base is derived from English and Welsh data, many tools are applicable to services in Scotland and Northern Ireland.

All resources are provided free of charge.


To read more about the research and evidence supporting the REDUCE toolkit, visit the University of Bristol REDUCE study website:




The REDUCE study provides clear insights for frontline staff on what practices are associated with improvements to outcomes including length of stay for hip fracture, which will often be relevant to other non-ambulatory fragility fractures. We know that the potential benefits of adopting these practices could be significant, which is why we are recommending orthopaedic trauma services to consider the insights coming out of REDUCE to help improve length of stay. The study’s cost-benefit calculator will support trusts to do this, and we strongly encourage trusts to make use of it.

GIRFT February 2023

logos for Reduce, University of Bristol and Versus Arthritis

Meet the REDUCE study team

University of Bristol researchers

Prof. Celia Gregson

Prof. Andrew Judge

Prof. Yoav Ben-Shlomo

Prof. Rachael Gooberman-Hill

Dr Rita Patel

Dr Sarah Drew

Dr Elsa Marques

Dr Petra Baji

Dr Katie Whale

External Collaborators

Jill Griffin, Royal Osteoporsis Society

Prof. Antony Johansen, National Hip Fracture Database, RCP London

Dr Kassim Javaid, University of Oxford

Prof. Xavier Griffin, Queen Mary University of London

Mr Tim Chesser, North Bristol Hospitals NHS Foundation Trust


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