The National Hip Fracture Database monitors and provides guidance for the improvement of care in older patients admitted to hospital with fragility fractures of the femur in the UK. The latest annual report encompasses data from 2020 and 2021 and demonstrates how care compares with that prior to the COVID-19 pandemic. It builds on the detailed analysis of six original Key Performance Indicators (KPIs) that track care through the hospital care. It also seeks to look forward with innovations including new KPIs designed to examine the very first and final stages of each patient’s care pathway by adding in an indicator on the use of nerve blocks to manage pain before surgery and ensuring access to ongoing bone strengthening up to 120 days post-surgery. It also highlights the evolution of care in injuries throughout the femur.

Key recommendations from the report are based on specific indicators and include: 

Will Eardley, Surgeon and NHFD surgical clinical lead, states that the report “ provides an overview of patient management from early phases of interaction between Emergency Departments and receiving wards, through perioperative care and onward rehabilitation. We encourage the reader to reflect on the two new Key Performance Indicators enabling assessment of care at the very first and final stages of each patient’s care pathway.

Antony Johansen, NHFD orthogeriatrician clinical lead, notes that the Audit is moving to a new era of quarterly reporting, which will allow teams to use the live data on the NHFD website to inform governance meetings and local improvement work. Dr. Johansen states that “The challenges facing health care in the UK mean that services are developing rapidly and need to be able to respond quickly to problems as they arise. The new Quarterly Governance Tool is an opportunity for team members and trainees from all disciplines to make use of the data available on the NHFD website as a driver for QI”.

Do you want to share your quality improvement work in a peer reviewed journal?

The Fragility Fracture Network (FFN) under the leadership of the Hip Fracture Recovery Research Special Interest Group (HFRR) and BMJ Open Quality are pleased to announce that a collaborative supplement on healthcare improvement work in fragility fracture will be published in the early summer 2023:

'Fragility Fracture Network Innovations in Healthcare Improvement: a special supplement’.

Papers can be submitted on any aspect of healthcare improvement in the field of fragility fracture in any of the following categories:

- Systematic review
- Narrative review
- Research and reporting
-Short report
-Quality improvement report (please follow BMJ Open Quality’s template)
-Quality improvement programme
-Quality education report

Additional information:

If you have a topic you would like to submit:

Minimum Common Dataset to measure performance

The use of national registries to track the management of hip fracture patients has been shown to improve care in healthcare systems in an increasing number of countries around the world.  A project undertaken by the Hip Fracture Audit Special Interest Group of the Fragility Fracture Network (FFN) has examined which questions are consistently used in the ten best established national registries. A global consensus method was then used to establish a revised minimum common dataset (MCD), which sets out just 22 key questions which any audit needs to ask, along with additional optional questions that might be useful depending on the specific needs of different countries. The revised MCDs help to profile the whole patient pathway: pre-surgery, surgical, post-surgical care and rehabilitation, and can be used as a clinical audit by clinicians and policy-makers to compare actual performance with best practice and to drive improvement of hip fracture services within their organization or country. The work and the datasets are described in a paper released in the Bone and Joint Journal in June 2022.  For additional information you can contact ­
­Read the paper here!­
FFN is proud to have the opportunity to make available some excellent resources that were developed by the Australian and New Zealand Hip Fracture Registry  (ANZHFR). The ANZHFR launched the Hipcast podcast series in March 2021, with the aim of improving management of patients who have sustained a hip fracture. FFN has worked with the Registry team to identify the podcasts that meet the needs of an international audience including 11 sessions that address issues such as: anaesthesia, surgery, rehabilitation, secondary fracture prevention and frailty. Information is provided in an easy to listen way using experts from across the globe, including researchers and front-line clinicians. The podcasts can be accessed here. For those interested in hearing more of the Hipcast series,  you can tune in on most podcast platforms (Apple podcasts, Amazon Music, Spotify) or go to If you have any questions or suggestions for future Hipcast episodes, please contact­
An article released this week in Archives of Osteoporosis describes efforts to improve the care and prevention of fragility fractures in New Zealand from 2012 to 2022, including the development and implementation of a systematic approach to care and prevention for New Zealanders with fragility fractures, and those at high risk of first fracture.
The paper presents a multi-year initiative which started in 2012 when Osteoporosis New Zealand developed and published a strategy with objectives relating to people who sustain hip and other fragility fractures, those at high risk of first fragility fracture or falls, and all older people. In 2017, a national alliance was formalised under the Live Stronger for Longer programme, which includes stakeholder organisations from relevant sectors, including government, healthcare professionals, charities and the health system. Outputs of this alliance include development of Australian and New Zealand clinical guidelines, clinical standards and quality indicators and the launch of a bi-national registry that underpins efforts to improve hip fracture care. All 22 hospitals in New Zealand that operate on hip fracture patients currently submit data to the registry. This is supported by an approach to improve secondary fracture prevention for people who sustain fragility fractures through nationwide access to world-class Fracture Liaison Services. At this time, widespread participation in national registries is enabling benchmarking against clinical standards as a means to improve the care of hip and other fragility fractures in New Zealand. An ongoing quality improvement programme is focused on eliminating unwarranted variation in delivery of secondary fracture prevention and future plans include progression of existing initiatives, as well as the introduction of new initiatives to address primary fracture prevention in a systematic fashion.
“As advocated in the Global Call to Action on Fragility Fractures, multidisciplinary, multisector collaboration is required to improve outcomes for people who sustain fragility fractures,” said Adj. Assoc. Prof. Paul Mitchell of Osteoporosis New Zealand. “This has been a real team effort, and we are committed to ensuring that all New Zealanders who experience these fractures receive excellent acute care, rehabilitation and secondary fracture prevention,” Mitchell added.
­The Fragility Fracture Network (FFN) is seeking nominations for Board and Executive Committee (ExCom) members who will be elected during the FFN’s Annual Congress, 20-22 October 2022. Terms will begin immediately after the Congress. 
­Board MembersThere will be at least two open elected board positions. The position is a term of 2 years with 6 meetings hosted virtually a year and required attendance at 4.  Executive Committee (ExCom) positionsThis year we are creating a Chair elect position for all our executive positions therefore we are seeking the following ExCom posts:President-ElectTreasurer-ElectGeneral SecretaryGeneral Secretary-ElectChair of the Regionalization CommitteeChair of the Communications CommitteeChair-Elect of the Communications CommitteeChair of the Education CommitteeChair-Elect of the Education CommitteeChair of the Scientific CommitteeChair-Elect of the Scientific Committee Nomination ProceduresIf you are interested in a position please note the following information:Each individual needs to be a member of FFN.A new nominee must be nominated by 2 FFN members (other than themselves). These individuals will need to be named on the application form. Those who are applying for re-election do not require nominators.Each post will be elected separately, so nominees can apply for more than one position.An individual may be nominated for multiple posts. If elected to one post, their name will be removed from other posts.Submission requires a short summary of your experience with fragility fractures and information on what you would bring to FFN. Each is a maximum of 200 words.                 ­
­Additional information about the positions is available at Nominations Job Descriptions Final.docx or by contacting­
­Applications need to be submitted here.­
­­­­­­­BMC Geriatrics open for submissions: 1 September 2022­­
­­Addressing falls and fragility fractures in older adults is necessary. To date, falls and fragility fractures are still causing a long-term burden of disability and costs worldwide. Focusing on orthogeriatrics and comprehensive interdisciplinary approaches is mandatory.  Optimizing innovative inter-professionals methodologies and inter-generational processes and technologies may be a strategy to improve patients’ and systems’ goals and to promote active and valuable aging. The Fragility Fracture Network (FFN) is on the front line to promote the cultural discussion and upgrading educational tools to improve falls and fragility fractures prevention, and the optimal management of orthogeriatric patients.  This BMC Geriatrics collection about “Falls, Fractures and Orthogeriatrics” may offer the opportunity to address:the healthcare and the economic burden associated with falls and fragility fractures worldwide; the frailty associated with or underlying falls and fragility fractures, the need for a comprehensive assessment and interdisciplinary management of people living with falls and fragility fractures; the patients’ and systems’ gains associated with the orthogeriatric co-management and the interdisciplinary models of care associated with fragility fractures, from hospital admission to rehabilitation short- and long-term programs; the increasing burden of peri-prosthesis fractures secondary to falls and the issues associated with surgical, rehabilitation and recovery of quality of life;the reasons for lack of evidence about efficacy, valuable and sustainability of available falls and fracture prevention programs;the opportunity and the impact of innovative programs for secondary prevention to overcome the schism between “bench and bedside” evidence. Orthogeriatrics, fall and fragility fracture prevention are crucial milestones in achieving quality human longevity. We encourage the submission of manuscripts to BMC Geriatrics Collection dedicated to Falls, Fractures, and Orthogeriatrics.  Click on the image below to submit your manuscript.­­

Now available in seven languages

We're pleased to announce the dissemination and evaluation of a global strategic response for improving musculoskeletal health and acting on rheumatic diseases. In 2021, the Global Alliance for Musculoskeletal Health (G-MUSC) published the report Towards A Global Strategy To Improve Musculoskeletal Health. It outlines a roadmap for health systems internationally on ‘what’ can be done to improve musculoskeletal health and rheumatic diseases, and importantly ‘how’, across contexts and settings. The roadmap was co-designed by the global community, comprising 678 individuals and 116 organisations from 72 countries. Originally published in English, the report has now been translated into Arabic, Simplified Chinese, Hindi, Brazilian Portuguese, Latin American Spanish and Swahili. Access the translated reports here. Please respond to the 5min survey to share your thoughts on the value of these products.­­­

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