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The tide has turned

The tide has turned. Response on behalf of the British O rthopaedic Association Miss Clare M arx CBE FRCS. The challenge to T&O. 70,000 hip fractures amongst 300,000 fragility fractures a year

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The tide has turned

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  1. The tide has turned Response on behalf of the British Orthopaedic Association Miss Clare Marx CBE FRCS

  2. The challenge to T&O • 70,000 hip fractures amongst 300,000 fragility fractures a year • Care and rehabilitation of patients with hip fracture is the central challenge for trauma services; those that can provide good care for these patients will cope well with the range of other fragility fractures encountered.

  3. BOA Blue book 2007 Four big messages Multidisciplinary approach to the management of fragility fracture patients Reliable secondary prevention osteoporosis falls Chronic disease model Quality assurance the NHFD

  4. National Hip fracture data base

  5. A series of firsts • Recommendations of the profession accepted by DoH • The program led to a change in the payment system (Best Practice Tariff) • Use of the NHFD – a non DoH data base for monitoring the compliance • The establishment of the fracture fragility steering group at the DoH to take it forward into the wider Health care setting

  6. NHFD data 2010

  7. NHFD data 2010

  8. NHFD data 2010

  9. BPT Compliance in Q1 and Q2

  10. Turning the tide

  11. Drivers for change • Standard setting by professional organisations championing multidisciplinary working • The recognition that robust data enables change, research and quality improvements • Best Practice Tariff which takes clinical standards and rewards performance against those standards monitored by NHFD

  12. Summary • As a profession we must collaboratively champion change and be prepared to work for real quality improvements for our patients • The Best Practice Tariff has lead the way as a model for changes in commissioning of services

  13. Conclusions • We welcome the focus this report brings on Care of the older patient undergoing emergency surgery • Although we have further to go in T&O, recent developments have turned the tide • This NCEPOD does not go far enough in challenging the commissioners of the future to ensure that standards of care are delivered

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