Our teams caring for around 500 patients annually with broken hips (fracture neck of femurs) have made huge strides to bring care up to meet Best Practice Guidance. Patients suffering fractured neck of femurs often have lots of complicated needs, many are in their 80s and 90s.

In order to meet Best Practice Guidance we have to provide seven components of care between admission and discharge. Two years ago less than 10% of our patients achieved it across the board. Last year this rose to 30% and this year it is 60%. Some hospitals achieve 85% so there is still work to do to maintain and continue these results, but ours are still trending upwards. So far this year an extra 100 patients have achieved all the components of Best Practice standards compared to last year.

Orthopaedics General Manager Andrew Bottomley said: "We have made our standards as important to our teams as the 4-hour standard is to the emergency teams. It is top of everybody's agenda and given real prominence. That is how seriously we take it.”

"This injury can be a really horrible one, we want to improve the quality of recovery and improve survival rates for our patients.”

All members of staff involved in the pathway – including nurses, trauma coordinators, surgeons, doctors and ortho-geriatricians -  have contributed to the improved results. Everyone from A&E, theatres and the ward teams are responsible. Andrew added: " From the beginning to the end, every person who is a part of that team is committed to the pathway because they know it gets more patients back to their own home, reduces distress while they are staying with us and saves lives. They impress me every day."

Key factors of delivering Best Practice include reviewing medications, mental health tests for conditions such as delirium, falls assessments are also part of the standards in this complex area of care.

Andrew said: "This is very much ongoing, we have to maintain our efforts. If you fail on just one of the component you lose the overall rating. It's gone, and a patient has missed out. We have to continue to work hard to build on this and to ensure we improve, the trend suggests that is the way we are heading."