New guidance on hip fracture services will improve recovery for thousands of patients

The ROS, in collaboration with researchers from the University of Bristol, has today (6 March) launched a new ‘toolkit’ for senior doctors and hospital managers, that will help make changes to their organisational arrangements and improve the quality of hip fracture care across the UK.

The guidance was developed after the REDUCE study last year carried out by the University of Bristol, and funded by the charity Versus Arthritis, found that how well patients recover after a hip fracture varies enormously between NHS hospitals in England and Wales.

Every year more than 70,000 older adults are admitted to a UK hospital after a hip fracture, which can lead to decreased quality of life, emergency hospital readmission after discharge and increased risk of death.

Significant findings from the study show that the way hospitals deliver patient care is linked to longer term patient recovery. The researchers identified that patients had a lower risk of dying in hospitals where hip fracture staff met regularly to discuss feedback from patients as a team. In addition, in hospitals where staff were able to get at least 90% of hip fracture patients out of bed the day after surgery, patients stayed in hospital on average two days less.

Described by one early adopter as 'a seriously comprehensive masterpiece', the toolkit addresses different aspects of the care pathway, providing guidance on training, clinical team planning, service specifications, quality improvement and patient discharge, making it easier for hospitals to improve the service they provide.

Jill Griffin, Head of Clinical Engagement at the ROS was core investigator on the project. She worked with Celia Gregson, Professor in Clinical Epidemiology and Orthogeriatrician at the University of Bristol and chief investigator of the study, to develop the guidance which will now be hosted on the ROS website.

Jill Griffin, said:

“The research findings have given us valuable information and shown us how we can work with healthcare providers and hospitals to improve patient recovery after a hip fracture.

“The study data has enabled us to make recommendations that we have used to build this toolkit for healthcare professionals and our aim is that it will dramatically improve the quality of care for everyone who suffers a hip fracture.”

Getting It Right First Time (GIRFT) is a national programme designed to improve the treatment and care of patients through in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change.

Mr Bob Handley, Orthopaedic Trauma Surgery Clinical Lead from GIRFT, said:

“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.”

The toolkit is freely available to all healthcare professionals and service managers on the ROS website here.