20,000 who need hip ops left waiting in agony for over 36 hours

THOUSANDS of elderly people with broken hips are being forced to wait in agony for days for an emergency operation, official figures reveal.

Strict NHS guidelines say over-60s arriving at hospital with a fractured hip should receive surgery the same day or the next – and should certainly wait no more than 36 hours.

But figures show nearly one in three elderly patients – more than 20,000 a year – have to wait longer to receive an emergency hip operation.

Experts last night said the picture was ‘deeply concerning’ and blamed growing pressure on hospitals.

The findings come as research reveals waiting more than two nights for a hip operation does not just leave people in pain but also puts them at risk of death.

Scientists from King’s College London and universities in Canada found leaving a patient for more than two nights before surgery increased mortality risk by 16 per cent.

The researchers, writing in the Canadian Medical Association Journal, said surgeons should never ‘let the sun set twice’ before operating on a broken hip.

Yet 31.2 per cent of over-60s arriving at NHS hospitals with a broken hip had to wait more than 36 hours for surgery in June, according to the figures collected at 177 NHS hospitals in England, Wales and Northern Ireland by the National Hip Fracture Database.

This is a huge rise since February 2015 – when only 22.1 per cent had to wait so long.

The most common reasons cited for delays are lack of theatre space and cancellation due to other operations overrunning.

Caroline Abrahams, director of charity Age UK, said: ‘Experts are clear about the importance of early surgery following a hip fracture so it is deeply concerning that one in three older people are not getting the operation they need within the recommended timescales.

‘This failure is not only leaving many older people in unnecessary pain and distress, it is also undermining their chances of making a good recovery and of retaining their mobility and independence.’

The findings mark the latest in a series of concerns over the care available to hip patients in Britain. Earlier this year the Mail revealed three-quarters of trusts were refusing to fund routine hip and knee operations unless patients were in very severe pain.

And last month the British Medical Journal reported that 1,700 patients had been refused hip and knee operations last year even though doctors had pleaded their cases. The new

‘Puts patients at risk of death’

figures paint an even more alarming picture as they relate to emergency surgery for a bone break, rather than the routine ‘elective’ operations to replace a worn or arthritic hip.

Paul Dixon, of the British Orthopaedic Association, said: ‘The importance of early surgery for patients who have suffered a fracture of the hip has long been recognised… indeed, both NICE guidelines and British Orthopaedic Association Standards for Trauma have recommended surgery on the day of, or day after, injury for several years.’

Dr Dixon added that there was little doubt that ‘ pressures faced by the NHS’ had contributed to the increase in delays.

The new research suggests mortality rates do not change if patients receive an operation on the day of admission or the day after.

But if surgeons wait until the third day there are an extra six deaths for every 1,000 operations, and if they wait until the fourth day or later there are an extra 11 deaths.

A 2017 audit of hip operations by the Royal College of Physicians (RCP) found that 42 per cent of delays longer than 36 hours were due to ‘administrative’ or ‘logistic’ reasons such as lack of space or cancellations due to overruns. That report estimated that if these factors were eliminated then 81.7 per cent of patients would be able to have operations on the day of, or the day after, admission.

The NHS is currently under major pressure due to the summer heatwave, which has driven emergency admissions up 6.3 per cent higher than last year.

A record 2.2 million patients attended A& E in England in July, figures show.

An NHS England spokesman said: ‘NHS waits for operations are now dramatically shorter, and patients are being seen far quicker – thirty years ago 200,000 people were waiting over a year, now it’s fewer than 5,000.

‘And over the coming year the NHS is funding more waiting list operations, including for hip and knee conditions, and we are encouraging hospitals to use this funding to ramp up their elective operating now.’