People who suffer hip fractures are waiting too long for treatment, a report says.

The Audit Commission, which called for improvements in the service five years ago, criticised hospitals saying not enough changes have been made in that time.

A total of 66,000 people a year fracture their hips in the UK, most of whom are over 75.

But the commission found that only 7% of patients are admitted to hospital wards from accident and emergency departments within the recommended one hour.

And half of patients are still waiting for their operation after 24 hours.

Almost half of hospitals cancel operations for potentially avoidable reasons, the report adds.

A previous report in 1995 called for physicians to work alongside orthopaedic surgeons, but only 23% of hospitals have adopted this practise.

Junior doctors

There had been improvements in some areas - the proportion of operations carried out by junior doctors has fallen from one-in-ten to one-in-100 during the past five years, and the number of patients waiting more than 48 hours for an operation has fallen slightly from 22% to 18%.

Andrew Foster, Controller of the Audit Commission said: "Although there has been some improvement in the length of time people wait for their operation, much more needs to be done. It is unacceptable that one in five people have to wait more than 48 hours for an operation, at a time when they can be in pain and in shock.

"Although some hospitals have improved their treatment of people with fractured hips, in too many cases performance has either not improved or got worse. These ones need to fundamentally rethink their processes to ensure that patients receive the prompt attention they need."

The British Medical Association supported the call for further improvements.

Chairman of the association's committee for consultants Dr Peter Hawker said: "The bottom line is that elderly patients should have every right to expect that they will receive high quality care.

"We know that they are much more likely to die if they have to wait more than 48 hours for surgery. Delay is therefore unacceptable. Trusts must learn from the hospitals that are performing best and put organisational effort and resources into improving services."

The Department of Health said it had issued guidance that older peoples' services should be given priority.

A spokesman added: "Our forthcoming national service framework for older people will for the first time set national standards and define service models for the care of older people."