The Royal College of Physicians | Falls and Fragility Fracture Audit Programme
National Hip Fracture Database
Part of the Falls and Fragility Fracture Audit Programme
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Annual reports

NHFD 2019 annual report


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NHFD 2019 annual report

Rise in older patients receiving innovative tests for delirium

          • One in ten patients are still not receiving timely orthogeriatric assessment
          • One in five patients are still not able to get out of bed on the day after surgery
          • Wide variation in the type of hemiarthroplasty implants being used - significant cost implications for the NHS
          • Improvements in 120 follow up rates are still needed, with only around two-thirds of patients being recorded as returning to their original pre-fracture residence
          • Increased numbers of hip fractures during winter months add to pressures on services and contribute to increased hip fracture patient mortality at this time
          • Screening for delirium is becoming more consistent, as this has improved the proportion of patients known not to have post-operative delirium

          The latest National Hip Fracture Database (NHFD) annual report describes a new approach to the continuous monitoring of case-mix adjusted 30-day mortality, that aims to improve the identification and support offered to outliers from 2020. However, mortality is not the most important outcome. Patients often place greater emphasis on the avoidance of distressing complications such as delirium, and on success in returning to their original home, and this explains the emphasis placed on these in the NHFD’s key performance indicators.

          Supporting documents