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National update on The Falls and Fragility Fractures Audit Programme from Dr Helen Wilson

Helen WilsonHelen Wilson

Dr Helen Wilson presented in London today and gave a national update on The Falls and Fragility Fractures Audit Programme. The Falls and Fragility Fracture Audit programme sits within the clinical effectiveness and evaluation unit at the Royal College of Physicians.  It incorporates three national audits funded by HQIP.  Helen discussed the history of this programme and provide an update on its current work.

Falls Audits
National audit of the organisation of service for falls and bone  health in older people 2006, 2009, 2010
National clinical audit of falls and bone health in older people 2007
Feasibility Audit of inpatient falls 2011 - Helen said that this looked at inpatient falls- this was not a national audit so the data was incomplete

"Updated guidelines in 2013 and since then a further feasibility study has been created and is the process of being finalised"

NICE QS for Falls in Care Settings

Quality Standards:
Set ambitious but achievable goals for NHS
About 12-16 high-level statements based on NHS Evidence accredited sources
Include potential measurement sources through which providers of NHS funded care can demonstrate the quality of their services to commissioners
National audits are a key source of evidence of compliance

Helen went on to  explain the Six Standards of Care
Patients admitted to an orthopaedic ward within 4 hours
Surgery within 48 hours
Orthogeriatric medical support
Pressure sore assessment and minimisation
Bone Health assessment
Multidisciplinary falls risk assessment

Expansion of Orthogeriatrics
In 2003 only 4% of Trusts had shared care
11% were intending to implement
In 2009 20% of Trusts had five or more ward rounds per week
In 2013 50% of Trusts had five or more ward rounds per week
57% patients are seen pre-operatively by orthogeriatrician

Helen emphasised that we must have clear guidelines for your audit of practice and based on NICE guidelines

Important document for Falling Standards, Broken Promises in 2010

Run charts are very useful to show management and help with business cases to improve quality of care- incredible useful charts to show performance

It was very ambitious to try capture fragility fractures, and difficult to create a data base on these fractures as lots of different types are missed

Fragility fracture in the UK- rough estimate 350000 symptomatic fragility fractures- even though this is an estimate this number is still good to work on!!

Best practice tariff structure has gone up from £480 to £1500 for each patient and this has been very effective for hip fractures

Helen concluded her presentation by saying that "Audits working together will help to drive forward and prevent overlap".

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Events of interest:

Legal Issues in End of Life Care Masterclass
Wednesday 14 January 2015 London

Legal Issues in End of Life Care Masterclass
Tuesday 10 March 2015 London

Deprivation of Liberty Safeguards: Ensuring Compliance in Practice
Wednesday 25 March 2015 London

Legal Issues in End of Life Care Masterclass
Tuesday 19 May 2015 London

Download: Helen Wilson Presentation

5 November 2014


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