title: The impact of helipad designation on meeting the best practice tariff for fractured neck of femur cases in a major trauma centre.
abstract: Hip fractures represent a significant burden to the NHS: the cost for all UK hip fractures is approximately £2 billion and in 2013, 64 838 people were admitted to hospital with a fractured neck of femur (FNOF). In April 2010 St George's NHS Hospital was designated one of four Major Trauma Centres (MTC) in London. Following MTC designation, in April 2014 St George's Hospital opened a helipad. This study aimed to assess the impact of the helipad designation on the Trust's ability to meet the Best Practice Tariff (BPT) criteria for FNOF patients. Two samples were analysed: 'pre-helipad' (from October 2013 to March 2014) during which 125 patients presented with FNOF, and 'post-helipad' (from April 2014 to September 2014) during which 122 patients presented with FNOF. The percentage of cases receiving surgery within 36 h, receiving joint care of a consultant geriatrician and a consultant orthopaedic surgeon, and receiving assessment by a geriatrician in the perioperative period were found not to have been negatively impacted by the helipad. However, completion of routine recommended assessments including admission using the agreed assessment protocol (96.6% vs. 50%, p < 0.05) and completion of two Abbreviated Mental Test (AMT) scores (74.7% vs. 58%, p = 0.007) were found to have been compromised.
authors: Trauma and Orthopaedics, St. George's University Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK. Electronic address: johndabis1@gmail.com.
authors: John
authors: J
authors: Dabis
authors: University of Cambridge, The Old Schools, Trinity Lane, Cambridge, CB2 1TN, UK. Electronic address: aliyahhussein@gmail.com.
authors: Aliyah
authors: A
authors: Hussein
authors: Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia. Electronic address: markrickman@me.com.
authors: Mark
authors: M
authors: Rickman
mesh_terms: D000369:Aged, 80 and over; D017732:Air Ambulances; D005260:Female; D005265:Femoral Neck Fractures / Q000175:diagnosis* / Q000601:surgery*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D013222:State Medicine; D013997:Time Factors; D014193:Trauma Centers / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D006113:United Kingdom
keywords: Aircraft; Environment; Femoral neck fractures; Trauma centres