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Call to ‘right the wrong’ of hip fracture patients wait for physio at home


By Angela Sharda
9 February 2018

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Better handover is needed to avoid hip fracture patients facing waits of up to 80 days to see a physiotherapist at home after their discharge from hospital, health leaders said.

The call comes after an audit for the Chartered Society of Physiotherapists found that continuity of care for some patients was lacking with some waiting nearly three months for physio at home.

Better handover is needed to avoid hip fracture patients facing waits of up to 80 days to see a physiotherapist at home after their discharge from hospital, health leaders said.

The call comes after an audit for the Chartered Society of Physiotherapists found that continuity of care for some patients was lacking with some waiting nearly three months for physio at home.

Professor Karen Middleton, chief executive of the CSP, said:‘Too many people are missing out and righting this wrong is one of the pressing issues of our time.

‘Hip fracture patients who do not receive rehab soon after leaving hospital risk depression, deteriorating health, and losing their mobility.

‘This can bring not only further costs and pressures for the system, but more importantly, devastating consequences for the individual and their families.’

'Serious, life-changing injury'

The  investigation  followed the amount of physiotherapy given to 6,000 patients in 131 hospitals over 120 days to get a picture of  the care available for inpatients and when they go home.

Hip fracture ‘is a serious, life-changing injury’ that mainly affects people in their 80s, who may have pre-existing medical conditions, CSP said.

It is the most common cause of injury related adult death and costs the NHS and adult social care £1b a year.

Patients stay on average for two weeks on their first ward and are either discharged or move to another ward or hospital within two weeks.

Long waits

Although discharged patients waited an average of  15 days for physiotherapy, the audit found that some were still waiting up nearly three months later.

Some patients were getting less than an hour’s physiotherapy a week after they left hospital.

One in ten community services said they did not get any handover from hospital teams.

One in five services maintained the continuity of rehabilitation  with an average of  no more than 1 week between discharge and the start of therapy at home.

In the first week  staff spent nearly two hours on therapy – around half the time provided spent on inpatients.

Co-ordinated approach needed

The CSP called for commissioners to consider a co-ordinated approach to rehabilitation to help patients back on their feet and regaining their confidence after surgery.

Therapists should also ensure that their patients  ‘continue uninterrupted rehabilitation when they return to their own homes’, it said.

CSP also called for  a review of  local referral structures between hospital services and community therapy teams ‘to ensure that these are suitable for handover of the personal needs of individual patients’.

NICE guidelines state that after surgery, hip fracture patients should be offered rehabilitation at least once a day. The survey revealed four out of ten (43%) missed a day’s therapy due to no physios being available.

Professor Middleton added: ‘We must invest in transforming acute and community services to ensure access to high quality rehab and continuous care for all those who need it.’

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