Long delays for hip fracture physio
9th February 2018 – Hip fracture patients, once discharged from hospital, can find themselves waiting up to 80 days for a physio to visit them at home, according to a report.
Figures collected by the Chartered Society of Physiotherapy (CSP) additionally show a third of hip fracture patients are also being failed in hospital by not getting the rehabilitation they need and there are 'unacceptable variations in care'.
The CSP audit is the largest of its kind and used data from 5,989 hip fracture patients who attended 127 hospitals between May and June last year.
A hip fracture is a crack or break at the top of the thigh bone, close to the hip joint.
It is common in older people and is usually the result of a fall. More than 1 in 3 women over 50 will be affected by a hip fracture.
Surgery is usually the only treatment. In around half of cases this means a complete or partial hip replacement. In other cases, plates, screws or rods are used to fix the fracture.
After a hip operation it's important for recovery that patients are helped up as soon as possible after surgery. However, the CSP audit found hospitals were failing to achieve this for a third of people.
The day after their operation the audit found only 68% of patients managed to get out of bed.
Professor Karen Middleton, chief executive of the CSP, says hip fracture patients who receive high quality and intensive rehab in the first week after surgery have the best chance of recovery.
The major audit found the patient's transition from hospital to home wasn't always smooth and in 1 in 10 cases community services received no handover from the hospital team.
One in 5 patients received home physiotherapy within a week of being discharged from hospital but, on average, they had to wait 15 days, and some patients had to wait up to 80 days.
The audit also revealed the amount of rehabilitation patients received varied greatly, with some patients getting less than 1 hour a week.
Professor Middleton, says not receiving rehab soon after leaving hospital puts hip fracture patients at risk of depression, deteriorating health, and loss of mobility.
The audit found only 1 in 5 services (20.5%) successfully maintained the continuity of their patients’ rehabilitation, providing optimal care and the best possible chance of recovery.
Iona Price, deputy chair of the Falls and Fragility Fracture Audit Programme says patients need to raise concerns with their GP if they are unable to access the rehab they need.
NHS England says the commissioning of physiotherapy is the responsibility of local NHS commissioning groups called CCGs.
In a statement a spokesperson says: "Access to physiotherapy does vary across the country which is why NHS England is working with doctors to help them to provide better and more consistent care in all areas. This includes providing expert advice to local health bodies to reduce variation and improve care for patients."
The Welsh Government issued a statement saying: "Whilst we do not recognise these figures, we recognise the importance of receiving rehab at home as soon as possible after leaving hospital and expect all patients to be seen in a timely manner."