Focus on hip fracture

This report explores the quality of care and outcomes of treatment for hip fracture, drawing on 10 years’ of hospital inpatient activity data.

Hip fracture is one of the most common and serious health problems affecting older people. With an ageing population, providing high quality care for people suffering from a hip fracture is becoming increasingly important.

Looking at 10 years’ of hospital inpatient activity data, we found that the number of hip fracture admissions increased by 15.5 per cent between 2001/02 and 2012/11. The increase appears to be mainly due to the general ageing of the population.

The management of these hip fractures in the NHS has changed over this decade, generally for the better, with reductions in 30-day mortality rates and length of hospital stay, and an increase in the proportion of people undergoing surgery within 48 hours of admission.

There is room for improvement in primary and secondary hip fracture prevention services as the population level rate of hip fracture has not decreased

The data points to changes in patterns of care for older people, with shorter lengths of stay but higher levels of readmission being observed. These are consistent with patterns of acute care found elsewhere and an indication of changes in wider health and social care systems.

These data also indicate changes in the population, with a growing community of people surviving hip fracture, with increasing frequency of admission. This group of people will most likely have significant health and social care needs.

There is room for improvement in primary and secondary hip fracture prevention services as the population level rate of hip fracture has not decreased. 

The fact that we are not reducing the incidence of hip fractures, coupled with variations in outcomes at a regional level, suggest a possible reconsideration of prevention strategies is needed.

Suggested citation

Smith P, Ariti C and Bardsley M (2015) Focus on hip fracture. Research report. Nuffield Trust and Health Foundation.