New recommendations say timely surgery and follow-up treatment, including physiotherapy, for hip fractures can reduce patients’ hospital stay and get them back on their feet sooner. The guidance comes from the National Institute for Health and Clinical Excellence (NICE), and advises on the management of hip fracture – from hospital admission, through to the patient’s return home and discharge from care.
Hip fractures are a big issue for the NHS in the UK. Around 70-75,000 hip fractures occur each year, with figures expected to rise to 100,000 by 2020 due to the ageing population. The cost of care for hip fractures is currently estimated at £2 billion a year. An additional factor is the high death rate after a hip fracture. Around one in three people die within 12 months.
Under its key priorities, NICE recommends hip fracture patients should be offered surgery on either the same day, or the day after, admission. It also recommends patients should be offered a physiotherapy assessment and medical mobilisation the day after surgery, with at least daily mobilisation after this. And it says from admission, patients should be offered a ‘Hip fracture programme’ supported by a multidisciplinary team – including physiotherapists – who will work out a care plan to help patients regain mobility and independence, including supported early discharge if appropriate.
Janet Thomas, chair of the CSP professional network AGILE (the Association of Chartered Physiotherapists Working with Older People), said: ‘Particularly important for patients who are elderly is the recognition for orthogeriatric assessment and early multidisciplinary goal setting. ‘Overall, this guideline supports physiotherapists to deliver early assessment, focused interventions and mobilisation of hip fracture patients, together with continuing rehabilitation in all settings, whether in an early supported discharge, intermediate care or a care home setting.’