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Older PeopleJan 19, 2024

Take 'urgent action' to prepare for an inevitable rise in numbers of older people with hip fractures

The number of patients with hip fractures in Scotland is going to surge over the next decade, according to the results of a study published in The Bone & Joint Journal earlier this month (1 January). The increase will result in an annual NHS shortfall of more than £25 million, according the four authors from the Scottish Hip Fracture Audit, Public Health Scotland.

One of the authors is Luke Farrow, a clinical research fellow at the University of Aberdeen who chairs the Scottish Hip Fracture Audit Quality Improvement and Research Sub-group, which led the research. He said: ‘A clear, comprehensive national plan is needed now to manage the future burden of hip and other fragility fractures.'  

Dr Farrow and his colleagues used data from the Scottish Hip Fracture Audit from 2017 to 2021 and statistical forecasting techniques to predict the annual number of hip fractures from 2022-2029. Their analysis showed that from 2017–2021 the number of annual hip fractures increased from 6,675 to 7,797 - and forecast this would rise to 10,311 by 2029 (a 32 percent increase from 2021). Extrapolating from these figures, they predict there will be 28 hip fractures a day, up from 21 at the last count.

Photo Credit: University of Aberdeen
Luke Farrow: more than 25 million a year needed to cope with more patients by 2030

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Based upon these projections, the total overall length of hospital stay following hip fracture in Scotland would increase by a total of 60,699 days per year, incurring an additional cost of at least £25 million a year.

Fragility fractures of the femur already have one of the highest levels of overall 'acute care bed burden' in the country, and Mr Farrow and his colleagues suggest hospitals will need about five extra acute hip fracture beds to deal with this increased activity. 

The increasing health and social care burden of fragility trauma, driven by an ageing population, is one of the major challenges facing the NHS over the next 10 years. We need to act urgently [Luke Farrow]

Dr Farrow explained: ‘Our predictions show that there is a need for a clear national plan for tackling the future burden of all fragility fractures, which should include a big public health focus on fracture prevention measures such as reducing falls in older adults and osteoporosis, weak bone, treatment.  

‘NHS healthcare services, including those that cater for hip fracture patients, are already significantly stretched. If the projected increases are not accounted for in future workforce, theatre capacity and bed planning then there is a real risk that the services will not be able to cope with the increased demand, and the quality of care that patients receive may diminish as a result.  

‘It is likely that this would likely have a knock-on effect of increased patient mortality and further strain on healthcare services managing complications associated with sub-optimal treatment that might have otherwise been avoided.'

Dr Farrow added: ‘The increasing health and social care burden of fragility trauma, driven by an ageing population, is one of the major challenges facing the NHS over the next 10 years. We need to act urgently in order to ensure we have adequate resources to appropriately manage these increases otherwise care will likely suffer significantly as a result.’ 


Projection modelling demonstrates that hip fracture burden and incidence will increase substantially by 2029, driven by an ageing population, with substantial implications for health and social care services.

To access the full version of the article  – titled The impact of an ageing population on future increases in hip fracture burden: insights from the Scottish Hip Fracture Audit  – click (payment may be needed)



Author: Ian A McMillan
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