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Improving Care for Hip Fracture Patients

News and Presentations for today's Hip Fracture Summit – learning from the 2018 NHFD findings and improving progress against the NICE quality standard for hip fracture.

Learning from the findings of the National Hip Fracture Database to improve outcomes for Hip Fracture patients
Prof Cameron Swift
, Emeritus Professor, Consultant Physician Kings School of Medicine, Chair of the NICE Guideline Development Group for Hip Fracture (CG124), lead/specialist participation Quality Standard Development, Member NHFD Advisory Committee
Professor Cameron Swift Chaired the NICE Guideline Development Group, & subsequent Quality Standard Topic Expert Group for Hip Fracture (CG124, QS86) (2011, 2012).  He has also been a member of the NICE Falls Clinical Guideline Development Group (GDG) and Quality Standards Advisory Committee that developed the core national guidance (CG24/161; 2004/2013) and updated Falls Quality Standard (QS86) (published in January 2017).  He continues to serve as an expert member in current updates of NICE guidance (2014) and Quality Standards (2016-17) on both of these topics, and has been a member of the Advisory Group to the National Hip Fracture Database.  In the past, he served as Physician to the DOH External Reference Group for the England National Service Framework for Older People, and in this capacity chaired the Working Party for Standard 6 (Falls & Fractures). He is a physician and clinical pharmacologist, Emeritus Professor of Health Care of the Elderly at King’s College London, and a past President of the British Geriatrics Society.  He served for 6 years on the Committee on Safety of Medicines, and a further five on the Medicines Commission.
Full PowerPoint Presentation

Improving the Quality of Hip Fracture Care
Dr Marilyn Browne
, Consultant Geriatrician, University Hospitals of North Midlands NHS Trust
Pre Event Abstract 
The service at Stoke has developed and changed dramatically over the past 15 years. It started with 2 sessions a week, and now has 5 sessions a week. The team has developed and refined the multidisciplinary pathway every year, so that it meets the needs of staff and patients. The team is fortunate in now having a hip fracture ward, with 36 beds and a small day room, so that the needs of this group of patients can be met 
Our unusual staffing model, using 2 Advanced Nurse Practitioners as the main providers of day to day care for the patients, has worked very well. We have had to deal with the challenge of having an additional 200 patients each year from the Stafford area from 2015 onwards without any significant extra resources being provided. In addition the loss of community beds has meant patients stay longer on the ward than before, as step down beds are more difficult to access. We aim to ensure that patients are not delayed in getting to theatre as a result of medical problems that could be sorted out promptly. We have developed an A-Z for hip fracture patients, which includes guidance re stopping anticoagulants; this aims to try to keep delays to surgery for anticoagulated patients to a minimum. We have run a monthly Mortality and Morbidity meeting for several years ; this is an excellent forum in which to review deaths and  any other morbidity issues that are relevant .These meetings are attended by the lead Hip Surgeon , a Consultant Anaesthetist , the anps , the Ortho -Geriatricians and therapy and nursing staff also.
​Full PowerPoint Presentation

Improving the Anaesthetic and Surgical Care Pathway for Hip Fracture
Mr Martyn Parker,
Consultant Surgeon, Peterborough and Stamford Hospitals NHS Foundation Trust
Pre Event Abstract
In Europe more than one third of adult women will sustain an osteoporotic fracture, with men having a risk of about half this. For those who reach the age of 80 years a hip fracture (or proximal femoral fracture) is the commonest type of fracture sustained and it is this fracture that is associated with the most mortality and morbidity. Hip fracture is now the most frequent reason for an elderly person to be admitted to orthopaedic care in Europe with these patients occupying up to one third of acute orthopaedic beds. Globally the numbers of hip fractures is expected to rise to 2.6 million by the year 2025 and between 7.3-21.3 million by 2050. Much of this increase in numbers is predicted to occur in India and Asia. Over the years the average age of hip fracture patients has progressively increased to that of 81 years. In addition the patients who sustain a hip fracture are of lower physical health than age matched controls. It is these factors, which account for the considerable mortality and morbidity that still prevails following a hip fracture. Clinicians should move away from using treatments based on historical practices or local preferences, to those that are derived from careful evaluations and summaries of all previous medical research on that topic. These evidence-based decisions are made using the best scientific evidence available from the world literature. For hip fractures we are fortunate that all the key randomised trials to date have been included within the relevant Cochrane review for each topic. These systematic reviews have formed the basis for the NICE guidelines on hip fracture care. 
​Full PowerPoint Presentation

Related Events:

Hip Replacement as a Day Case: Reducing Length of Stay & Improving Outcomes
Friday 20 September 2019 
De Vere West One Conference Centre, London

Falls Prevention & Management in Older People Reducing falls and harm from falls
Friday 20 September 2019 
De Vere West One Conference Centre, London

Delirium Prevention, Assessment and Effective Management
Monday 23 September 2019 
De Vere W1 Conference Centre, London

7 June 2019


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