Hip fracture care in 2024 (NHFD)

Reports | Published: 11 Sep 2025

Room for Improvement from the National Hip Fracture Database (NHFD), which is part of the Falls and Fragility Fracture Audit Programme (FFFAP), is based on data from 2024. This report examines how care aligned to the audit’s three patient goals of: getting to the right place; getting up after surgery; and getting back home again. In relation to the first goal, it found that patients spent an average of 15 hours waiting before they were made comfortable in a bed, on a ward appropriate to their needs.

NHFD data have been used to develop a toolkit, which [lead to] a cost saving of £676 per patient

Other key findings include:

  • A quarter of people who break their hip will have another fragility fracture in the future – the majority (56%) do now receive bone strengthening medication, but 10 hospitals (6%) discharged over three-quarters of patients without them receiving effective bone protection
  • Inequalities in hip fracture care and outcome for people of different ages, sexes or ethnicities were not found.

This report also includes five recommendations for improvement, including the fact that ICBs and healthcare planners in Wales and Northern Ireland should require:

  • Emergency and orthopaedic departments to agree fast-track admission policies, so that at least one in five patients reach a specialist orthopaedic ward within 4 hours of admission with a hip fracture
  • Each hospital to commission appropriate physiotherapy capacity so that all inpatients recovering from hip fracture can receive at least one session of physiotherapist-directed rehabilitation each weekend
  • All hospital teams to review their use of injectable bone protection, so that at least half of all patients are recorded to be on bone strengthening medication 4 months after a hip fracture.

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