The information is not available in the request format.

Data within the Hospital Episode Statistics database is not recorded at patient level i.e. we are unable to provide a count of how many people suffered a hip fracture as required as the data relates to admissions. It is possible for a single person to have more than one admission in any given time period.

Admissions data with a primary diagnosis of hip fracture, and where there was an external cause of fall, for patients aged 65 and over is below:

Source: The Health and Social Care Information Centre, Hospital Episode Statistics

Healthcare in Northern Ireland is the responsibility of the Northern Ireland Executive. Data for England is not collected centrally.

Data concerning the average length and cost of a finished admission episode for people admitted to hospitals with fragility fractures in each of the last five years is not held centrally.

Clinical coders at the Health and Social Care Information Centre have advised that it is not possible to identify fragility fractures from the ICD10 classification of diseases used in the Hospital Episode Statistics database, therefore the cost cannot be identified.

The following table provides a count of finished admission episodes where there was a primary or secondary diagnosis of fractures attributable to osteoporosis amongst men, women and genders not specified for the age groups requested for the period 2013-14.

Notes:

1. A finished consultant episode (FCE) is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which they end. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.

2. The number of episodes where this diagnosis was recorded in any of the 20 (14 from 2002-03 to 2006-07 and 7 prior to 2002-03) primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record.

Source: Hospital Episodes Statistics (HES) Health and Social Care Information Centre.

In the absence of guidance from the National Institute for Health and Care Excellence (NICE), it is for National Health Service commissioners to take funding decisions on treatments based on an assessment of the available evidence.

NICE issued interventional procedures guidance on the insertion of metal rib reinforcements to stabilise a flail chest wall in 2010 that recommends that the procedure may be used provided that normal arrangements are in place for clinical governance, consent and audit. NICE interventional procedures guidance makes recommendations on whether procedures are safe and efficacious, but does not provide guidance on whether the procedure should be funded in the NHS.

NHS England’s National Clinical Director for musculoskeletal (MSK) conditions, Peter Kay, is currently working in partnership with the Arthritis and Musculoskeletal Alliance (ARMA), to develop new MSK clinical networks across England.

The work ARMA has done to date has been very successful in capturing examples of best practice in MSK care across England, bringing together health professionals and commissioners and building a strong consensus on the way forward for models of care for MSK patients across the entire MSK community. Work is ongoing in this area and NHS England and ARMA are in dialogue about the nature of such support.

NHS England is undertaking a review of the role, purpose and function of the sub-regional infrastructure that it funds, which is focussed on supporting commissioners and providers to improve the quality of services including Strategic Clinical Networks (SCN), Clinical Senates and Academic Health Science Networks. The purpose of the review is to understand how the best value can be secured from the investment in these functions, in support of commissioners and providers in improving quality. This review is ongoing and is expected to reach its conclusions by the end of March.

Regarding plans to introduce MSK networks as part of the SCN programme, NHS England has made clear that as priorities change, or should the work of one of the initial SCNS conclude, it will identify new conditions or patient groups that would benefit from an SCN approach.

The provision of fracture liaison services (FLS) and falls services is a matter for local clinical commissioning groups (CCGs). NHS England advises that it is aware that provision of good FLS is not uniform across the country and it continues to work with CCGs to support them to develop appropriate local FLS services. It also advises that the FLS model recommended by the International Osteoporosis Foundation and the National Osteoporosis society is recognised as best practice and is being promoted.

In addition to this, the guidance from the National Institute for Health and Care Excellence Falls: assessment and prevention of falls in older people sets out best practice for clinicians on the management of patients aged 65 and over who are susceptible to falls.

The provision of fracture liaison services (FLS) is a matter for local clinical commissioning groups (CCGs) and data on numbers is not collected centrally. NHS England advises that it is aware that provision of good FLS is not uniform across the country and is working with CCGs to support them to develop appropriate local services. It also advises that the FLS model recommended by the International Osteoporosis Foundation and the National Osteoporosis society is recognised as best practice and is being promoted.