Third of broken hip victims have to wait two days for surgery

A report says around one in three broken hip victims had to wait more than 48 hours for surgery - a delay that could have put their lives in danger.

Four out of five spent more than two hours in A&E before getting a hospital bed, fewer than a third were properly assessed ahead of surgery and barely half were put on treatment to prevent further fractures.

Most of the delays were caused by "organisational issues", despite Government guidelines which aim to cut the toll of falls each year, says the report from the Royal College of Physicians.

It carried out the first national clinical audit of the care received by patients who had fallen and broken bones, including hip, wrist and spine. Its damning conclusion is that local trusts are "nowhere near meeting national standards and guidelines".

Most provide an "inadequate service and there are unacceptable variations in care across England, Northern Ireland and Wales".

Each year some 300,000 patients - mostly the elderly with thinning bones - are treated for fractures caused by falls.

The number is expected to double by 2050.

Campaigners called the findings "shameful" and claimed the healthcare system was "blighted with age discrimination".

Nick Rijke, of the National Osteoporosis Society, said: "Hip fractures have now reached 75,000 a year and are steadily increasing, yet most are preventable.

"To the shame of the Department of Health, hip fractures alone are resulting in the deaths of more than 1,000 people a month.

"We have to do so much more to prevent, diagnose and treat osteoporosis, reduce fractures, save lives and improve the quality of life of thousands of people."

He said hip fractures alone cost the NHS more than £1.73billion a year and hip fracture patients occupy one in five orthopaedic hospital beds.

Pamela Holmes, of Help the Aged, said: "It's a huge worry that most local services are still poorly coordinated.

"Our healthcare system is blighted by age discrimination and this is, sadly, another example."

The audit, commissioned by the Healthcare Commission and carried out by the RCP's Clinical Effectiveness and Evaluation Unit, covered 157 primary care trusts.

It found:

• 80 per cent of people with hip fractures spent more than two hours in A&E departments - "against best practice" - before transfer to a ward.

• 31 per cent of operations for hip fracture were delayed beyond the 48-hour "best practice" target; 29 per cent of hip operations were delayed due to organisational issues.

• Fewer than a third of patients had a pre-operative medical review by a suitably- trained physician.

• Most patients returning home after a fragility fracture were not offered a falls risk assessment.

• Even after surgery, less than half were put on osteoporosis treatment.

Amanda Hutchinson, Healthcare Commission head of long-term conditions and older people, said: "For older people a fall can have serious consequences for their physical and emotional well being.

"They can immobilise them and prevent them from carrying out their normal day-to-day activities, leading them to feel isolated, frustrated and depressed. They can even be fatal."

"But with access to well-organised care, information and support older people can continue to lead active and fulfilling lives."

Health Minister Ivan Lewis said: "I am issuing guidance today to support best practice in this area and will consider the range of recommendations made within the report."