Studies show that in some hospitals, one in 10 people died within a month of surgery which is more than three times worse than in the best.
It has been identified that getting patients into theatre quickly and out of bed the next day for physio are key ways to improve care. Researchers say that people should receive the same, high-quality care wherever they live.
An NHS spokesperson has however said hip fracture care in the UK had “seen dramatic improvements in recent years”.
People who are mostly affected by hip fractures are older people who are frail, have poor balance or other serious health conditions, and surgery is almost always needed. Several teams within a hospital are needed which includes continuing support and physio after they have returned home.
Prof Celia Gregson, who led the study of more than 170,700 patients in 172 hospitals between 2016 and 2019 says, “If you get it right for older people with hip fractures, you’re probably getting it right for older people in general.”
‘Huge shock to the system’
Hilary Buck, 62, from Bath, was in excruciating pain after she fractured her hip on a camping trip with friends last year, tripping over a tent guy rope. But it took four days before she was transferred to a hospital where she could have an operation.
After she had a full hip replacement with bolts and pins inserted in her pelvis, she was subsequently diagnosed with osteoporosis which causes the bones to weaken and break more easily.
Hilary says; “This was a huge shock to the system, and it has completely changed my life in so many ways. I’m slowly recovering but there is still a lot of stuff I can’t do. I have to be much more cautious in my approach to life generally and can’t do some of the sports I used to, such as skiing, tennis and kayaking.”
Hilary went home three weeks after her fall and an hour later, she had a visit from an occupation therapist. She also regularly has the help of physios and carers. Hilary says she has received a lot of help to enable her live independently again.
According to the Bristol study, some hospitals manage to send hip-fracture patients home 12 days after surgery, on average, while others send patients home after a one month stay on average.
Studies also show that the risk of a patient dying within 30days after surgery ranged from 3% to more than 10% while the chances of being readmitted ranged from 3% to nearly 33%.
Researchers are of the opinion that there are three main things hospitals should do to provide better care. These are;
- Get patients to surgery within 36 hours of being admitted to hospital
- Get patients back on their feet with physiotherapy the day after surgery
- Hold staff meetings to discuss feedback from patients
It has also been found that if hospital staff got 90% of hip fracture patients out of bed the day after surgery, those patients spend two fewer days in hospital compared with hospitals that took longer.
Meeting this target according to the researchers will save 16,550 bed-days a year in England and Wales.
‘Worrying state of care’
Prof Gregson said making arrangements for continuing care was also vital for patient recovery.
“The fact that some hospitals discharge patients into the community without knowing when follow-on care might start is a sad reminder of how disjointed hospital and community services can be across the country,” she said.
She also added that the Covid pandemic put extra strain on the NHS and is likely to have made the situation worse, saying that the main challenger remains getting people with hip fractures to theatre quickly.
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