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NHS hospitals are failing to provide adequate care for elderly people who have suffered falls and fractures, an in England, Wales and Northern Ireland has found.

The Royal College of Physicians found "unacceptable variation" in the quality of services for treating and preventing broken bones caused by slips and trips.

Despite modest improvements on previous years, gaps in provision persist and deficiencies in care remain widespread.

Ministers say change is happening.

Paul Burstow, Minister for Care Services, said: "Every part of the NHS should be learning from this audit to make sure they are adopting best practice.

"The government is promoting prevention and investing in services to help people with their rehabilitation and NICE [the National Institute for Health and Clinical Excellence] is putting in place new quality standards."

Victims of falls and fractures, above the age of 65, occupy hospital beds for a total of more than four million days a year in England alone, at an estimated cost of £2bn.

Every year in the UK, more than 500,000 older people attend hospital emergency departments following a fall, and 200,000 suffer fractures due to osteoporosis.

Information on nearly 10,000 patients from all NHS acute trusts, or equivalent, in England, Wales and Northern Ireland, as well as primary care organisations, mental health trusts and a sample of care homes, revealed only 37% provided any kind of fracture-liaison service to prevent future fractures.

Many of the patients had received inadequate acute assessment and care.

A third of those with hip fractures had not received pain relief within an hour of arriving in hospital.

And only 33% of non-hip-fracture and 60% of hip-fracture patients had received appropriate treatment for osteoporosis.

More than 90% of sites said they used a tool that assessed balance and mobility, but in reality only 34% of patients with fractures of the wrist, arm, pelvis or spine had received an assessment.

Dr Jonathan Potter, who was involved in the audit, said: "Once again it is starkly apparent that what organisations say they provide is not matched by what people receive.

"There is real urgency to ensure effective assessment and management for people who fall and in the very least to ensure evidence-based fracture-liaison services are established in all trusts."

Michelle Mitchell, of the charity Age UK, said: "Falling and breaking a bone can have serious, life changing consequences for older people - one of which is that they are much more likely to suffer falls in the future.

"It is extremely worrying then that in many areas of the country, people who have already broken bones are not receiving the treatment and support to avoid future injury including the lack of referral to comprehensive falls-prevention services."