NHS targets 'harm hip patients'

Hip fractures are a common cause of morbidity

The lives of elderly patients with hip fractures are being risked by hospitals diverting resources to meet NHS waiting list targets, warn surgeons.

The British Orthopaedic Association says almost all cases should be operated on within 48 hours.

But a poll of 124 of its surgeons suggests a fifth of patients wait longer than this.

Over half said their hospital prioritised elective surgery over emergency cases to meet targets.

The Department of Health said doctors should prioritise patients based on clinical needs.

However, more than 40% of the surgeons surveyed believed trauma care was worse since the 18 week target - from GP referral to treatment - was introduced in 2004.

It cannot be right for emergency patients in great pain and in need of swift treatment to have to wait John Black, president of the Royal College of Surgeons

Lack of specialised geriatric medical support to get patients fit for surgery, low commitment from NHS management and shortages of dedicated theatre time for trauma were cited as main causes for the operating delays.

Clare Marx, president of the BOA, said: "The system is letting down our oldest and frailest patients in too many hospitals.

"These patients come to hospital in extreme pain and distress, they often have other long-term medical conditions and may be confused or have dementia.

"They are a group who are complicated to manage clinically and are not at present an NHS management priority."

Clinical priorities

John Black, president of the Royal College of Surgeons, said: "It cannot be right for emergency patients in great pain and in need of swift treatment to have to wait.

"The NHS should allow surgeons the flexibility to treat these patients as a priority offering a proper service to this large and ever increasing group of patients."

Some 75,000 people in the UK suffer hip fractures each year - and these are set to double by 2050 with the ageing population.

This kind of fracture almost always occur in very elderly people following falls and requires urgent treatment to reduce pain, restore mobility and prevent disability or death.

The BOA says 95% of cases in people aged 60 and older should be treated surgically within 48 hours of the injury occurring.

A Department of Health spokesman said: "The Department has been very clear to the NHS that clinical priority is and remains the main determinant of when patients should be treated.

"Targets will not be allowed to override what patients themselves choose or what is in the patient's best clinical interests.

"The priority must be to ensure that urgent patients are seen as a matter of urgency - even if this means that some routine patients may need to wait a little longer.

"It is for clinicians, therefore, to take account of the impact any delay might have on the medical outcome of the patient."