Dorset County Hospital one of the best for dealing with hip fractures

And it says it is committed to improving where possible in dealing with an increasing workload.

Charity Age UK says hip fractures are a “serious threat to older people’s health”, and is calling for the prevention of falls to become a priority for the health service.

Dorset County Hospital dealt with 330 hip fractures during 2018, according to the latest annual National Hip Fracture Database report by the Royal College of Physicians.

Of these, 16 people died within 30 days of sustaining the fracture.

At 4.9%, the hospital had one of the lowest mortality rates of the 177 trauma units across England, Wales and Northern Ireland, where the average rate was 6.1%.

Hip fractures are the most common reason for admission to orthopaedic wards, according to the National Institute for Health and Care Excellence, mainly affecting older people who may suffer from osteoporosis, or weak bones.

Those who break their hip are at increased risk of suffering potentially fatal complications, including infections, pneumonia, and cardiovascular conditions such as heart failure or strokes.

The National Hip Fracture Database was established in 2007, and examines the quality of patient care across hospitals using a series of key performance indicators.

Since then, deaths within a month of a hip fracture have halved, with around 4,000 people dying during 2018.

However, the report states that “only a minority of patients will completely regain their previous abilities”, with increased dependency and difficulty walking meaning a quarter will need long-term care.

Hip fractures incur an annual cost of over £1 billion to health and social services – 1% of the NHS budget.

Of the patients treated at Dorset County Hospital, 121 (37%) had not been discharged to their home or original residence within 120 days of their injury.

Across England, Wales and Northern Ireland, this was the case for 31% of patients.

The report’s authors found “enormous variation” in performance across hospitals in some areas of care.

NICE recommends that patients who need surgery receive their operation either on the day they arrive at hospital or on the following day, to ensure people recover quickly and regain their mobility.

At Dorset County Hospital, 46 patients (14%) had to wait longer than this.

There were also delays for patients when being admitted to hospital, with only 65% of patients admitted to an orthopaedic ward within the target four hours.

And of those who underwent surgery, only 75% had one of the operations recommended by NICE guidance, with the rest undergoing a procedure that is not the one recommended for their type of fracture.

Altogether, the report found Dorset County Hospital only met best practice criteria in 63% of cases.

Medical Director at Dorset County Hospital Professor Alastair Hutchison said: “Dorset County Hospital deals with around 26 hip fractures per month, which are usually caused by a fall. Falls are very common among older people, especially in people aged 80 and over who may have reduced vision or mobility and balance problems. Sadly around one in 16 people who suffer a hip fracture will die within the following 30 days, but the chance of this happening can be reduced by rapid hip replacement and immediate physiotherapy so that the patient is back on their feet within 36 to 48 hours.

“At Dorset County Hospital our time from fall to operation is consistently good at around 25 hours compared to the national average of 33 hours, and only around one in 18 patients die within the first 30 days after fracture, which is again significantly better than the national average. Other indicators of quality of care that we monitor are early assessment by physiotherapists, nutritional assessment and assessment by a doctor trained in Elderly Medical Healthcare - all of which are particularly important for Dorset’s increasingly elderly population.”

Caroline Abrahams, charity director of Age UK, said it was “absolutely essential” that high-risk patients get access to high-quality care wherever they live.

She said: “Falls are a serious threat to older people’s health, wellbeing and independence, causing pain, distress and loss of confidence.

“However, despite having serious consequences, falls in later life are often dismissed as an inevitable part of growing older, when the reality is many of them are preventable.

“The quality of falls prevention services still varies a great deal from place to place. Preventing falls and hip fractures must be a priority for our health service.”