Record the frailty score on every hip fracture admission

The Clinical Frailty Scale takes less than a minute, is based on how the patient functioned before the fall, and predicts mortality after hip fracture. Recording it at admission gives the trauma coordinator a shared, objective way to decide who goes first when lists are full, and informs discussions about ceilings of care.

Ask family or carers about function two weeks before the injury rather than scoring the patient as they appear in the emergency department.

• Score frailty from function before the fall, using family or carers where needed.
• Record the score in the admission note and the trauma list.
• Use it alongside medical fitness to prioritise the order of hip fracture cases.
• Share it with orthogeriatrics to plan post-operative care.

Why it matters

Frailty is the factor most likely to make a wait dangerous.

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