Quality statements

Quality statements

Statement 1 Adults with hip fracture are cared for within a Hip Fracture Programme at every stage of the care pathway. [2012, updated 2016]

Statement 2 Adults with hip fracture have surgery on a planned trauma list on the day of, or the day after, admission. [2012, updated 2016]

Statement 3 Adults with displaced intracapsular hip fracture have a total hip replacement if clinically eligible, rather than hemiarthroplasty. [2012, updated 2017]

Statement 4 Adults with trochanteric fractures above and including the lesser trochanter receive extramedullary implants. [2012, updated 2016]

Statement 5 Adults with subtrochanteric fracture are treated with an intramedullary nail. [new 2016]

Statement 6 Adults with hip fracture start rehabilitation at least once a day, no later than the day after surgery. [2012, updated 2016]

In 2016, this quality standard was reviewed, and statements prioritised in 2012 were updated (2012, updated 2016) or replaced (new 2016). Statement 3 was updated again in 2017 (2012, updated 2017). For more information, see update information.

Statements from the 2012 quality standard for hip fracture that are still supported by the evidence may still be useful at a local level:

  • People with hip fracture have their cognitive status assessed, measured and recorded from admission.

  • People with hip fracture receive prompt and effective pain management, in a manner that takes into account the hierarchy of pain management drugs, throughout their hospital stay.

  • People with hip fracture are offered early supported discharge (if they are eligible), led by the Hip Fracture Programme team.

  • People with hip fracture are offered a multifactorial risk assessment to identify and address future falls risk, and are offered individualised intervention if appropriate.

  • People with hip fracture are offered a bone health assessment to identify future fracture risk and offered pharmacological intervention as needed before discharge from hospital.

The 2012 quality standard for hip fracture is available as a pdf.

NICE has developed guidance and a quality standard on patient experience in adult NHS services (see the NICE Pathway on patient experience in adult NHS services), which should be considered alongside these quality statements.

Other quality standards that should be considered when commissioning or providing services for people with hip fracture include:

A full list of NICE quality standards is available from the quality standards topic library.