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Elderly fracture care 'failing'

07/11/2007

Gaps and inequalities exist in NHS care for people who have fallen and fractured a bone, a new report claims today.

The Royal College of Physicians (RCP) says that most NHS trusts and primary care trusts (PCTs) are failing to meet national standards and guidelines on care of fractures of hip, wrist, arm, pelvis or spine.

It found that nearly a third of operations for a hip fracture were delayed beyond the 48-hours target, increasing the risk of death.

Less than a third had a pre-operative medical review by a suitably-trained physician and 80 per cent of those with hip fractures spent more than two hours in accident and emergency before being transferred to a suitable ward.

Problems were also found after patients had been discharged from hospital.

Less than a quarter of fracture patients were referred for exercise training to reduce future falls and three months after fracture only a fifth were receiving appropriate treatment for osteoporosis.

The report says the results are "worrying" and calls for PCTs to consider commissioning specialist services such as falls clinics to improve the care of their patients.

Its lead author, Dr Finbarr Martin, associate director at the RCP Clinical Effectiveness and Evaluation Unit, said: "Despite several years of national policy and clear evidence-based guidelines, local health services have much more progress to make in this vital clinical area for older people.

"The wide variation between the sites in this audit does show however what can be done, and it is up to local NHS commissioners, managers and clinicians to work together to provide for their local populations what only a few are currently achieving."