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

Facing new challenges - The National Hip Fracture Database report on 2020 (NHFD 2021 annual report)

This report focuses on the six NHFD key performance indicators used to monitor and drive up standards across the country. 2020 was a challenging year across trauma services, however performance on most of our KPIs remained stable or experienced only transient dips, which is a testament to the resilience of hip fracture services during the global COVID-19 pandemic. 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.

In response to the pandemic, the NHFD asked participating hospitals to record their patients' COVID-19 status from May 2020. As a result this report is also able to present 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 recommendations

• NHS leaders should use the NHFD data on COVID-19 to understand the course of the pandemic and its impact on frail older people in their unit
• Local hip fracture teams should review the NHFD KPIs for their unit and target KPIs highlighted as significantly below average for local QI work
• NHFD clinical leads should examine the data quality casemix run charts to ensure the data they provide are complete and of high quality
• NHFD clinical leads should review their mortality run charts when they are released each quarter; if either mortality line approaches the 95% control line this should trigger a review of the local picture provided by the NHFD website, perhaps complemented by a case note review

2020 marks the first year that patients sustaining non hip femoral fractures and periprosthetic femoral fractures have had their care recorded in a national audit alongside patients with hip fractures. Submitting these additional patients’ data to the NHFD allows healthcare teams and leaders to identify areas of inequality in access to key interventions such as prompt surgery and help shape the future of specialist surgical intervention for complex periprosthetic fractures. Dominic Inman, Surgeon, NHFD surgical clinical lead

Few aspects of healthcare have been untouched by the pandemic, but the number of people suffering a hip fracture has remained remarkably steady across 2020 and 2021. Hip fracture serves as a marker condition with which to understand the challenges of caring for older people in a modern health service. The NHFD’s website captures and publishes detailed data in real-time, including data on patients' COVID status, and this report therefore provides a unique picture of how well multidisciplinary teams pulled together in responding to the needs of their patients. Antony Johansen, NHFD orthogeriatrician clinical lead

Report launch webinar

The NHFD clinical leads Antony Johansen and Dominic Inman led a webinar on 13 December, discussing the 2021 annual report findings on 2020 data, including impact of Covid-19 on hip fracture services.
They were also joined by one of the clinical fellows, Jonathan Evans, who discussed and answered questions on treatment and management of peri-prosthetic fractures in 2020.
If you missed it a recording of the event is now available to watch on YouTube: