National Hip Fracture Database
National Falls and Fragility Fracture Audit Programme (FFFAP)
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Annual reports

NHFD 2020 annual report - A review of 2019 NHFD data

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Captain Sir Tom Moore

We would like to thank Captain Sir Tom Moore for his support for the NHFD and its aims to drive up the standards of care for hip fracture sufferers like himself. He is a shining example of what can be achieved after breaking a hip and is in many ways a symbol of the inspirational resilience of multidisciplinary teams across the country. As he says himself: "We have to keep on going."

            Images courtesy of Captain Sir Tom Moore
            and Emma Sohl, Capture the Light Photography.

            Antony Johansen, NHFD clinical lead

            "We have all lost patients, and many of us have lost colleagues, friends or family members at this terrible time, but I have been heartened by the resilience shown by multidisciplinary teams around the country. The NHFD serves as a quality improvement platform that encourages innovation by local teams and I look forward to sharing what others have learned and how hip fracture care has developed at a time when necessity is the mother of invention." Antony Johansen, orthogeriatrician, University Hospital Wales

The challenge of the next decade: are hip fracture services ready?

This report focuses on the six NHFD key performance indicators used to monitor and drive up standards across the country. 2019 saw improvements in all but one of these KPIs, but there remains significant variation. Policy-makers and front line teams should use this report alongside the live data presented on the NHFD website to reflect on their service and identify areas where improvements can be made.

2020 will no doubt prove to be one of the most challenging years in the history of the NHS. This report also presents the first data about the effect of COVID-19 on trauma units around the country and on outcome for patients with hip fracture who have COVID-19 when admitted to hospital or develop it after their operation.

Key findings, compared to 2018

• More patients received perioperative orthogeriatrician support
• Fewer patients received surgery on the day of, or the day after, their hip fracture
• More patients received the type of operation recommended by NICE
• More patients successfully got out of bed on the day of, or the day after, surgery
• More patients were shown to have avoided delirium when assessed after surgery
• More patients were discharged to their home or followed up to confirm they had done so

Key recommendations

• NHS leaders should use the NHFD data on COVID-19 to understand the course of the pandemic and the impacts on frail older people
• Hip fracture teams should review the NHFD KPIs for their unit and target below average KPI's with local QI projects
• Ward teams should reflect on the additional challenge of social distancing for frail older people and
   ensure they are offering patient information leaflets and carer support information
• Hospital managers should use the NHFD run charts for their hospital to understand the impact of the pandemic
• NHFD clinical leads should use the new NHFD casemix adjusted mortality run charts to check the quality of their data

Report launch webinar

NHFD clinical leads Dominic Inman and Antony Johansen discuss the report findings and answer your questions. FFFAP Patient and Carer Panel, Julia Ellis, also introduces a new and much-needed resource for family carers who have a loved one in hospital after a hip fracture. The webinar includes:

• Facing the challenge of COVID-19
• The report's key messages and recommendations
• An introduction to the new NHFD resource for family carers
• Q&A session

View now: NHFD webinar (Youtube - 90 minutes)

Key performance indicators (KPIs) 'caterpillar' charts for 2019

Supporting documents