Patients facing 'unacceptable' waits for broken hip surgery

VULNERABLE patients with broken hips are facing "unacceptable" waits for surgery in some NHS hospitals, a report finds today.

The audit said as many as 95 per cent of people with a hip fracture can expect to be operated on within the recommended two days but in other centres patients are forced to wait far longer.

Around 76,000 people fracture their hips every year in the UK and nine in 10 cases affect people in their 70s, 80s and 90s.

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The Royal College of Surgeons study uncovered wide variations in access to surgery but also in care designed to prevent future falls.

In some centres only 55 per cent of patients underwent operations within 48 hours because of "unacceptable" delays which slow recovery and cause pain and distress.

In Yorkshire, surgeons in Harrogate, York and Sheffield operated on 93-94 per cent of patients within 48 hours. But in Hull and Leeds only 63 per cent of patients had operations in the target time. The regional average was 81 per cent. Hospitals blamed delays on waits for operating theatres or beds, staff shortages and patients not being medically fit.

The audit, covering 129 hospitals, found access to assessments to check the risk of future falls also varied widely.

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In Bradford, Sheffield, Northallerton, Middlesbrough and Scunthorpe virtually all patients received the checks but in Scarborough only four per cent were assessed and one in 10 were checked in Huddersfield and Barnsley. This compared to the national average of 63 per cent, up from 19 per cent in 2009.

The audit revealed major variations in lengths of hospital stay for patients which will be a key focus in the future as the NHS sets out to cut costs.

Patients left hospital in Scunthorpe after treatment for hip fractures in 12 days. This compared to 26 days on average in Sheffield, although specialists are likely to have treated more complex cases there.

Surgeons said despite the variations, there had been major improvements in care in recent years. There was now far greater access to specialist care by geriatricians, screening for osteoporosis and more people left hospital on bone protection medicine than in the past.

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The report's lead clinician Rob Wakeman said big improvements could be achieved quickly, adding: "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."

The lead clinician in geriatric medicine, Colin Currie, said: "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."

The charity director at Age UK, Michelle Mitchell,said: "Falls represent the most frequent and serious type of accident in the over-65s.

"So it's very worrying that following a hip fracture, nearly one third of people aren't being given the appropriate medication, care and support to reduce the risk of falling and injury."