Best Practice Tariff Criteria
- Time to surgery within 36 hours from arrival in an emergency department, or time of diagnosis if an inpatient, to the start of anaesthesia
- Admitted under the joint care of a consultant geriatrician and a consultant orthopaedic surgeon
- Admitted using an assessment protocol agreed by geriatric medicine, orthopaedic surgery and anaesthesia
- Assessed by a geriatrician in the preoperative period: within 72 hours of admission.
- Postoperative geriatrician-directed multi-professional rehabilitation team
- Fracture prevention assessments (falls and bone health).
Trust receive an additional payment of £445 per patient.
Oakley et al looked at 2541 patients aged over 60 admitted with a neck of femur fracture. Looked at overall survival pre and post introduction of best practice tariff and found no significant difference. However, there was a significantly higher survival at 1 year and lower 30-day mortality in those who achieved Best practice tariffs.
Important to note that patients are more likely not to achieve BPT if unwell e.g. theatre delays whilst optimising.
Does achieving the best practice tariff improve outcomes in hip fracture patients? An observational cohort study