National Hip Fracture Database 2023 annual report
Source: data.gov.uk (2025-06-11)

National Hip Fracture Database annual report 2023. Hip fracture is a serious and costly injury affecting mainly older people, and is more common in women. It usually results from the combination of weak bone structure (osteoporosis) and a fall. Around 76,000 hip fractures occur each year in the UK as a whole. Although there is good evidence on best practice in surgical, medical and rehabilitation care following hip fracture, such care and its outcomes – in terms of return home and also of mortality – continues to vary.

The National Hip Fracture Database (NHFD), which was launched in 2007, aims to deliver improvements in the care of hip fracture patients. It documents case-mix, care and outcomes of hip fracture patients in England, Wales and Northern Ireland and is now, with almost 1 million cases on record – by far the largest hip fracture audit in the world.

It has demonstrated broad improvements at local and national level in patient care, and in England has supported the Department of Health’s highly successful Best Practice Tariff for hip fracture care. The work of the NHFD is now being replicated in Ireland, with the recent launch of Irish Hip Fracture Database, and similar developments are in hand in Australia and New Zealand, Canada and Hong Kong.

The National Hip Fracture Database was founded as a collaboration between the British Orthopaedic Association and the British Geriatrics Society. It was developed between 2004 and 2007, and since 2009 it has received central funding as a national clinical audit via the Healthcare Quality Improvement Partnership (HQIP). Since April 2012 the NHFD has continued as part of the Falls and Fragility Fracture Audit Programme (FFFAP), managed on behalf of HQIP by the Royal College of Physicians (RCP).

The audit covers England, Wales, Northern Ireland, Guernsey and the Isle of Man; however data files only refer to data for England and Wales.

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National Hip Fracture Database

National Falls and Fragility Fracture Audit Programme (FFFAP)

Annual reports
- 2025 (//www.nhfd.co.uk/2025report)
- 2024 (//www.nhfd.co.uk/2024report)
- 2023 (//www.nhfd.co.uk/2023report)
- 2022 (//www.nhfd.co.uk/2022report)
- 2021 (docs/reports2021)
- 2020 (docs/reports2020)
- 2019 (docs/reports2019)
- 2018 (docs/reports2018)
- 2017 (docs/reports2017)
- 2016 (docs/reports2016)
- 2015 (docs/reports2015)
- 2014 (docs/reports2014)
- 2013 (docs/reports2013)
- 2012 (docs/reports2012)
- 2011 (docs/reports2011)
- 2010 (docs/reports2010)
- 2009 (docs/reports2009)
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Related documents

15 years of quality improvement

The 2023 National Hip Fracture Database report on 2022

Key recommendations

• look at the guidance and resources on the Royal Osteoporosis Society website (https://theros.org.uk/healthcare-professionals/hip-fractures/reduce-hip-fracture-service-implementation-toolkit/) designed to improve patients’ recovery through better organisation of their care.

• review care in the Emergency Department (ED), so that patients are promptly seen, offered pain relief, and admitted to an appropriate specialist ward within four hours.

• use the NHFD website to see why surgery is delayed and work together so that this happens by the day after patients present with a hip fracture.

• use the NHFD website to see what can be done to avoid patients becoming confused so that they are well enough to get out of bed by the day after their operation.

• ensure that all patients are offered injectable bone strengthening treatment before leaving hospital, or followed up to support their continuing on oral forms of treatment.

Quality improvement focuses

The National Hip Fracture Database v1.0 © Copyright 2019 - 2026 HQIP/RCP Falls and Fragility Fracture Audit Programme (FFFAP)

(docs/CrownAudit)