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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

The tide has turned

Response on behalf of the

British Orthopaedic Association

Miss Clare Marx CBE FRCS

the challenge to t o
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.
boa blue book 2007
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

a series of firsts
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
drivers for change
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
summary
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
conclusions
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