Initiate: Increased mobility in hospital after hip fracture

Each year there are 70,000 new hip fractures in the UK. After this injury, mobility and independence are so badly affected that one in six people never return home. This downward spiral of immobility and dependence contributes to a quarter of people dying within one year of the injury. National mobility targets have been set for hospitals. Firstly patients should be helped out of bed within 48 hours of receiving surgery and secondly, they should receive two hours of rehabilitation per week. Patients whose care exceeds these targets seem to recover more quickly than other patients. Consequently, patients and their carers have asked if increasing ward-based mobilising, would allow people to get back home more quickly and to continue living independently. We want to find out if more ward-based mobilisation activity after hip fracture surgery allows people to get home more quickly and allow them to stay living in their own home longer. We will study 22 NHS hospitals. Half the hospitals will provide more mobilisation activities through additional staff and staff training, the other half will continue with what they usually provide. Thirty days after surgery we will check if patients have been able to return to the same living arrangements as before their injury. We will compare how quickly people get back home and continue living independently between the different hospitals to see if having more mobilisation activities in the first days after surgery is better than usual care. A few months later, we will ask patients about their quality of life, how well they can move around and how much care they received. Additionally, to explore the experiences of patients and key staff involved in this research we will carry out interviews when patients are discharged and again approximately 6 months later.