Background
Patient safety is a core priority for the NHS, but harm can occur in hospitals where patients who are already unwell may experience added risks such as falls or blood clots. Changes to medication in hospital require careful monitoring on discharge so advice given to patients on side effects is an important safety indicator.
Falls in hospital
Inpatient falls are one of the most commonly reported patient safety incidents. While most falls happen in people's homes, care homes or outside, some occur among patients already in hospital, who are often unwell and at greater risk. Many falls are preventable by removing hazards, addressing deterioration in muscle strength, balance and vision, staying alert to medication-related issues, and ensuring call bells, walking aids and slippers are within easy reach, along with prompt help when patients need the toilet.
The percentage of hip fractures that happen in hospital (rather than in homes, care homes and outside) is a measure of safety and the quality of care that older people are receiving in hospital.
In England, the percentage of hip fractures that were the result of an inpatient fall has decreased from 5% in April 2012 to 2.5 % in May 2026. In Northern Ireland, the percentage remained very low (<0.5%) until 2014 when it began to increase, reaching 2.8% in January 2017. Since then, levels have fluctuated. In May 2026, 1.8% of hip fractures in Northern Ireland were the result of an inpatient fall. Wales has recorded higher levels than both England and Northern Ireland since data collection began; a peak of 7.7% was reached in November 2013, but it has since decreased to 4% in May 2026. Note that it is the 12-month rolling average figures that are being reported here.
Pressure ulcers following a hip fracture
Immobility following a hip fracture can damage frail patients' skin, making prompt surgery and mobilisation essential to avoid patients being confined to bed and unable to carry out daily activities for longer than necessary. Immobility raises the risk of pressure ulcers (bed sores), so all patients should be offered help with repositioning and considered for pressure-relieving mattresses.
In England, the proportion of patients who are reported to have developed a pressure ulcer (grade 2 or above) following a hip fracture decreased from 3.7% in April 2012 to 2.2% in July 2019. However, since then there has been a consistent and concerning increase, to 3.4% in May 2025.
In Wales, the proportion fluctuated around 3% before increasing to 4.7% in September 2021. Since then it has declined, matching the percentage reported in England for October 2022 (2.8%) and falling below England for May 2025 (2.4%). The proportion has also fluctuated in Northern Ireland, with sharp increases and decreases over time. In the most recent years, the percentage fell from 2.8% in December 2018 to 1.1% in May 2024 and increased to 2% in May 2025. The smaller numbers of patients with a hip fracture in Wales and Northern Ireland may contribute to the greater fluctuation in rates observed.
Collecting data on pressure ulcer occurrence is one step to encouraging routine assessment of pressure sore risk. The identification and documentation of pressure sores may be a factor that could influence the data shown here, with higher rates potentially indicating more complete data collection.
Deaths from blood clots after leaving hospital
Preventing blood clots, medically known as venous thromboembolism (VTE), is a key patient safety priority. VTE includes both deep-vein thrombosis (DVT) and pulmonary embolism (PE), with risk highest after major surgery or injury, or in patients with heart failure, cancer or a heart attack. There is also an increased risk of deep vein thrombosis up to three months after Covid-19 infection, and pulmonary embolism for up to six months. Medicines can help prevent clots forming or dissolve vein blockages; without treatment, VTE can damage tissues or organs, and PE can be fatal.
This indicator measures deaths related to VTE within 90 days post discharge from hospital. Between 2007/08 and 2019/20, the rate patients who were admitted to hospital with any cause and died from a VTE-related event within 90 days post discharge from hospital decreased from 72 to 62 deaths per 100,000 adult hospital admissions. The absolute number of VTE-related deaths within 90 days post discharge from hospital increased by 13%, from 8,025 in 2007/08 to 9,030 in 2019/20 (data not shown), but the total number of adult hospital admissions increased by 32%, and so the rate of VTE-related deaths decreased.
At the start of the Covid-19 pandemic 2020/21, the rate of VTE-related deaths within 90 days post discharge from hospital increased considerably to 104 deaths per 100,000 hospital admissions, as a result of both increased numbers of deaths, given the increasing risk following infection, and also fewer admissions for other conditions. Between 2019/20 and 2020/21, the number of VTE-related deaths increased by 21% to 11,336, while the total number of adult hospital admissions decreased by 25% to just less than 11 million. Between 2020/21 and 2023/24, the rate of VTE-related deaths within 90 days post discharge from hospital sharply decreased to 61 deaths per 100,000 hospital admissions.
Risk assessments for the prevention of blood clots
All adult patients admitted to hospital must be risk assessed for VTE according to NICE guidance, so that preventative treatment can be given. This risk assessment has been a National Quality Requirement in the NHS Standard Contractsince 2014/15, requiring acute providers to assess at least 95% of inpatients each month. This target was met until 2019/20.
From April 2019, the target was expanded to include all inpatients aged 16 and over, so rates pre- and post-2019/20 Q1 are not comparable. In 2019/20 Q3, the proportion of adult inpatients who were risk assessed for VTE on admission to hospital was 95.3% for acute providers and 97.6% for independent sector providers. Data collection and publication were paused after 2019/20 Q3 and reinstated in 2024/25 Q1 (see ‘About this data’).
The target for DVT risk assessment has not been met by NHS providers since data collection restarted. In 2025/26 Q4, the proportion of adult inpatients who were risk assessed for VTE on admission to hospital was 92% for all providers of NHS-funded acute care and 94.4% for independent sector providers.
Inpatients informed about medication side effects upon discharge
Medication side effects are a significant cause of patient safety incidents. NICE guidelines state that patients should be involved in decisions about their medication, with the benefits, side effects and long-term effects discussed so they can make informed choices and better adhere to treatment. While patients vary in how much information they want, they should always be told about significant adverse effects and what to do if these occur.
Since 2020, respondents to the annual inpatient survey have been asked about the information they were given about any medicines they were to take home, and just 22% said they received an explanation of the side effects. By 2024, this decreased to 20%. Furthermore, 51% said they were given an explanation of the purpose of the medication, 41% were told how to take it, but 11% were given no information about their prescribed medicine (data not shown).
Until 2019, Adult Inpatient Survey respondents were asked, “Did a member of staff tell you about medication side effects to watch for when you went home?” The proportion of respondents who said that a member of staff ‘completely’ told them about side effects to watch for increased slightly from 36% in 2009 to 39% in 2015 but decreased again to 37% in 2019.
About this data
Hip fracture and inpatient falls
These charts use data from the National Hip Fracture Database. Both charts show 12 month rolling averages. Inpatient falls include patients who fall within the treating hospital as well as those who fall in hospitals that do not treat hip fractures (such as community hospitals) and are subsequently transferred for treatment. Patients are counted according to the year and month in which they were discharged from hospital, and patients under 60 years of age are excluded.
Venous thromboembolism (VTE)
NHS England data: This measures the proportion of adult hospital admissions during the analysis period who were risk assessed for VTE on admission, according to the Department of Health and Social Care/NICE National VTE Risk Assessment Tool. All providers of NHS funded acute hospital care, including foundation and non-foundation trusts and independent sector providers, are required to complete this data collection, which was mandated in June 2010. From April 2019 onwards the data covers patients aged 16 and over; before this it covered patients aged 18 and over. From April 2017 to March 2020 the data was published by NHS Improvement. Collection and publication were paused to free up capacity for providers and commissioners during the Covid 19 pandemic, and were reinstated in April 2024 using an unchanged methodology.
NHS Digital data: This measures the number of adults (19 years or over) admitted to hospital for any reason, not only episodes where VTE had been diagnosed, who subsequently died within 90 days of discharge where VTE was recorded on the Medical Certificate of Cause of Death (MCCD) as a condition leading to or directly causing death. This is expressed per 100,000 adult hospital admissions.
The surgical admission-based method uses unlinked data to calculate the number of discharges with ICD codes for deep vein thrombosis recorded in any secondary diagnosis field, divided by the total number of discharges among patients aged 15 and older.
Patient experience surveys
Data comes from the Adult Inpatient Survey. Two weights are applied to the results: a trust weight, so that each trust contributes equally to the England average, and a population weight, so that each trust's results are representative of its own sample without over representing particular groups, such as older respondents. Combining these two weights produces a single weighting that allows comparisons to be made between years. Comparisons across NHS services do not adjust for differences in survey populations, so results from different services are not directly comparable with one another.
For the 2023 Adult Inpatient Survey, patients aged 16 and over were eligible to take part if they stayed in hospital for at least one night during November 2023. Because the questions, terminology and methodology used in the survey were updated in 2020, results from 2020 onwards cannot be compared with earlier years.
Further information is available from the Care Quality Commission's Surveys pages.