BOA Reviews

At the British Orthopaedic Association (BOA), we are committed to continuously improving patient care and promoting excellence in orthopaedic services. As part of this mission, we offer two essential service reviews: Care of Patients with Non-Ambulatory Fragility Fractures (NAFF) Reviews and Elective Care Reviews (ECRs).

Multi-Disciplinary Clinical Service Review: Care of Patients with Non-Ambulatory Fragility Fractures (NAFF)

For over a decade, the BOA has been conducting service reviews for sites caring for older patients with fragility fractures, and we have successfully reviewed 25 sites during that time. The feedback from reviewed sites has been overwhelmingly positive, with participants stating that our reports are fair, impressively detailed, and instrumental in influencing necessary changes within their services.

These reviews are conducted by a multi-disciplinary team of senior clinicians from various specialties, ensuring a comprehensive evaluation of the care provided. Originally focused on hip fractures, we now extend our recommendations to encompass all patients with non-ambulatory fragility fractures (NAFFs). This broader group includes elderly and frail patients admitted with lower limb fractures and those with upper limb fractures that impede mobility.

Elective Care Reviews (ECRs)

Supporting orthopaedic units in enhancing the quality of their elective services is a top priority for the BOA. Our ECRs involve site visits by a review team consisting of BOA members and representatives from specialist societies such as the British Association for Surgery of the Knee (BASK) and/or the British Hip Society (BHS). These reviews focus on aspects of a Trust's hip/knee arthroplasty service, providing recommendations for improvement.

ECRs can be triggered by a Trust being identified as a persistent outlier by the National Joint Registry (NJR) or by a Trust's request based on other concerns or factors. The decision to undergo an in-depth review is always at the request of the Trust. While these reviews require significant effort from both the review team and the unit being reviewed, they play a crucial role in helping units identify areas for improvement and ultimately benefit patients.

If your Trust is interested in either a NAFF Review or an ECR, please email your enquiry to [email protected]. The BOA Policy Team will guide you through next steps.