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Meeting the NICE Quality Standard for Hip Fracture Care

News and updates from today’s Hip Fracture conference: Meeting the NICE Quality Standard and Learning from the NHFD Findings.

Following the findings of the National Hip Fracture Database Audit, this important and timely CPD certified conference, suitable for all members of the multidisciplinary hip fracture team focuses on improving care for hip fracture patients – implementing the 2015 NHFD recommendations 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
Chris Boulton, Project Manager, National Hip Fracture Database Advisory Group, Royal College of Physicians
PowerPoint Presentation

Driving improvement and improving outcomes
Emer Bouanem, Orthopaedic  CNS, Chelsea and Westminster NHS Foundation Trust
Powerpoint Presentation
Supporting abstract: “Redesigning our hip fracture care pathway to drive and improve better patient outcomes”

In an ever-growing, ageing population hip fracture is prevailing as a major public health issue, with its annual incidence projected to rise to 101,000 by 2020. The estimated annual cost of treating approximately 70,000 to 75,000 hip fractures each year is £2 billion. Policy-driven publications advocate best practice care standards for these individuals, who form a highly vulnerable and complex patient group with multiple co-morbidities and associated high mortality rates (BOA, 2007).  

Multiple national reports have highlighted the higher risk of morbidity and mortality associated with undergoing emergency surgery in the elderly (NCEPOD: An Age Old Problem, Mid Staffordshire NHS Foundation Public Inquiry). Age related decline in physiological reserve compounded by multiple co-morbidities, polypharmacy, frailty and cognitive dysfunction leads to poorer outcomes in this group. 

In recognition of these reports, standards of perioperative care have been developed from geriatric medicine and the Royal Colleges of Surgeons and Anaesthetists. The aims of peri-operative care were to:
•    Treat in a timely and dignified manner
•    Optimise rehabilitation by avoiding postoperative complications
•    Multidisciplinary approach
•    Develop protocol driven, integrated pathways

This presentation aims to inform the audience how we, as a trust, embraced a more collaborative approach to hip fracture care thus improving the patients’ journey and outcomes. Our compliance with the Best Practice Tariff care standards is analysed and potential solutions to emerging themes of non-achievement and challenges are discussed. 

The NHFD Annual Report, 2015 emphasised that the management of hip fractures takes the frail patient through a complex clinical pathway involving a wide range specialists, clinical teams, departments and agencies. In conjunction with our Consultant Nurse for Critical Care I carried out a recent case review of four hip fracture deaths. Common themes emerged, primarily that there is an insufficient HDU provision and inadequate response to the deteriorating patient.  I will share how I have led and directed a change in our practice, engaging key clinicians and members of the MDT, in order to sustain this service change through on-going project work.
Further reading:

British Orthopaedic Society & British Geriatrics Society (2007) The Care of Patients with Fragility Fracture:

NCEPOD (National Confidential Enquiry into Patient Outcome and Death) Report (2010): An Age Old Problem: A review of the care received by elderly patients undergoing surgery.

Future events of interest:

Setting up and running an Effective Falls Service
Tuesday 26 April 
ICO Conference Centre, London

Reducing Inpatient Falls & Harm from Inpatient Falls
Wednesday 18 May 
Colmore Gate Conference Centre, Birmingham

Setting up and running Virtual Clinics
Thursday 26 May 
Hallam Conference Centre, London

1 March 2016


    Partner Organisations

    The Tavistock and Portman NHS Foundation TrustInPracticeClinical Audit Support CentrePlayoutJust For Nurses
    GGI (Good Governance Institute) accredited conferences CPD Member BADS (British Association of Day Surgery) accredited conferences