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Health: 'Sub-standard care' for elderly hip patients identified
Elderly patients with broken hips are facing "unacceptable" waits for surgery in some NHS hospitals, according to a report out today.
While 95% of people with a hip fracture can expect to be operated on within two days, hours in some hospitals, others are forced to wait far longer.
An audit published by the Royal College of Surgeons found large variations in access to hip surgery and to care designed to prevent future falls.
Around 76,000 people fracture their hips every year in the UK, with 92% of cases among people in their 70s, 80s and 90s.
Today's audit found some hospitals, including Wansbeck Hospital in Northumbria, University Hospital Aintree, and North Tyneside General Hospital, managed to get 95% or more patients through surgery within 48 hours while others, including Charing Cross in London, Derriford Hospital in Plymouth and the Royal Victoria in Belfast only managed about 55%.
Reasons for delay include waiting for space on an operating theatre list, not enough staff, waiting for beds and patients not being
medically fit for surgery.
The audit, which covers 129 hospitals in England, Wales, Northern Ireland and the Channel Islands, said patients could see their health deteriorate while waiting for an operation.
Access to bone strengthening medication and assessment for further falls also varied widely, from 0% of patients in some hospitals to 100% in others.
While there were such variations, the National Hip Fracture Database National Report 2010 said there had been a big improvement in care in recent years.
There was now far greater access to specialist care by geriatricians, screening for osteoporosis and more people now left hospital on bone protection medicine than in the past.
Overall, the audit found 60% of patients received a falls assessment by the time they were discharged, with a further 3% awaiting a falls clinic appointment (63% total, up from 19% in 2009).
Some 57% of patients were admitted to an orthopaedic ward within four hours and 80% received surgery within 48 hours, up 5% on 2009 figures.
Overall, the audit covered more than 36,000 hip fracture patients treated in hospitals.
Lead clinician on the report, Rob Wakeman, a consultant orthopaedic surgeon in Basildon, said: "Hip fractures are threatening to overwhelm trauma and orthopaedic units, and it is the responsibility of clinicians and managers to work together to come up with solutions to improve patient care in their hospital.
"We are seeing lots of evidence from around the UK that big improvements in the quality of hip fracture care can be achieved in a short space of time.
"It is vital that those few units that are still under-performing use this guidance and the examples of best practice to improve services in line with the rest of the UK."
Colin Currie, lead clinician in geriatric medicine and a consultant geriatrician in Edinburgh, said: "The improvements detailed in this report are good news for patients and the NHS, but only a start.
"The human cost of hip fracture is enormous, and poor quality care can result in patients enduring avoidable pain, disability and even - worst of all - the loss of home and independence.
"Cost and quality of care are not in conflict because looking after hip fracture patients well is far cheaper than looking after them badly.
"So there is now absolutely no excuse for the sub-standard care that we
are still seeing in some hospitals."
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Saturday 11 February 2012
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