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Thursday, November 11, 2010

NICE issues draft guidance that broken hips should be operated on on the day of admission or the day after

NICE has issued draft guidance that broken hips should be operated on on the day of admission or the day after, as reported by the Telegraph, in order to reduce complications. The report states that "in some hospitals around half of patients wait longer than 48-hours for surgery even though evidence shows it doubles the risk of major complications and death."

Surely this is a no-brainer! If delay "doubles the risk of major complications and death," what on earth are surgeons thinking of? - How can they routinely be doubling the risk of their hip fracture patients (who are mainly elderly, and many of whom are frail and ill) suffering major complications and death? This is disgraceful. Is it an example of covert age discrimination?

The longer the delay, the more pain the patients will suffer, the more physiotherapy and other rehabilitation they will need, the longer stay in hospital, the more support/care at home. - All avoidable extra suffering, all avoidable extra expense.

I've never had a hip fracture, thankfully, but I've had a very complicated fracture of the humerus, which needed an operation. If I had had the operation within a few days, as I was promised on admission to the Northern General Hospital, I would have been back at home again within a week, I am sure, little the worse from the fracture. But because my agonising pain from the splint was discounted and it was almost a fortnight before the arm was operated on, there was massive damage to my right hand - mainly radial nerve palsy and ulna nerve injury - and my stay in hospital lasted a month instead of the few days it would have been with prompt treatment. My (dominant) right hand was completely unusable and intensely painful for months. No one in the system ever apologised or even expressed regret.

I needed many months of physiotherapy and occupational therapy before I could move the hand at all. - It takes you a few seconds to read that sentence. - Just think of having to cope with that yourself: months with a swollen hand, totally unusable and exquisitely tender to the slightest touch. And I have had to have carers to help me since then, though I previously had managed without. Are these inexcusable delays attributable to callousness, ignorance, incompetence or what? - They are certainly unnecessary and they benefit no-one.