Scottish Hip Fracture Audit
Figures from January to December 2019

About this release

This release by Public Health Scotland (PHS) provides information from the Scottish Hip Fracture Audit (SHFA) on patients with a hip fracture from January 2019 to December 2019.

Main Points

There was an improvement in almost every standard across Scotland in 2019 and although variation continued to exist between hospitals, the gap had narrowed and reasons for these variations are now more clearly understood.

Summary 2019 standard attainment

• The proportion of those who were back home (to original residence) didn’t change in 2019 and remained similar at 60%. There was no overall rise in readmission rates within 14 days of discharge suggesting that those individuals were ready to go home.
• The proportion of patients who died within 30 days of admission to hospital increased in 2019 to 7.7% from 6.9% in 2018 and no hospitals were outliers (either statistically better or worse than the Scottish average). This change is not thought to be significant and presents a normal variation in outcomes.

• There was no change in the acute length of stay (the time spent in an acute orthopaedic ward) and this remained at a national average of 9 days.
• Similarly, the national average total length of hospital stay for 2019 remained unchanged from the previous year at 17 days.

Background

People who suffer from a hip fracture are usually frail and elderly and at risk of complications from surgery and/or the injury and this can be associated with increased length of stay in hospital, admission to care homes and mortality.

The Scottish Hip Fracture Audit reports on compliance with the Scottish Standards of Care for People with Hip Fractures (external website). The results support the collaborative work between the Scottish Government, PHS and Health Boards to continually drive improvements in care for this group of people.

The second standard sets out the six interventions/ treatments that every patient with a clinical suspicion or confirmation of hip fracture should have, known as the “Big 6”. These are as follows: provision of pain relief (1), screening for delirium (2), early warning score system (3), full blood investigation and electrocardiogram (4), intravenous fluids therapy (5) and pressure area care (6).

The third standard sets out the four assessments that must be completed within 24 hours of admission to the orthopaedic/ receiving ward for patients with a hip fracture, known as the “Inpatient Bundle of Care”. These are as follows: delirium screening (1), falls assessment (2), nutritional assessment (3) and pressure area assessment (4).

Data are collected by Local Audit Co-ordinators based in each hospital and submitted to PHS for analysis and report production.

Further Information

The next release of this publication will be August 2021.