Increasing mobility in hospital after hip fracture.

Each year there are 70,000 new hip fractures in the UK, with an ongoing annual cost to health and social care services of £4.3 billion. Following surgery, 30% of patients are not returned to their usual home by 120 days. Current UK national standards for rehabilitation recommend two hours of physiotherapy in the first postoperative week. It has been shown that increasing the frequency and duration of physiotherapy could lead to more rapid recovery and earlier discharge from hospital, with more patients returning to their preinjury place of residence. However, the National Institute for Health and Care Excellence found this evidence to be insufficient to recommend a change in national guidelines. The World Hip Trauma Evaluation (WHiTE) 15: INITIATE is a two-arm, multicentre, cluster, randomized controlled trial with embedded process and economic evaluations. Half of the centres where these patients are treated will provide routine care, and the other half will provide routine care with increased duration and frequency of physiotherapy combined with strategies to increase mobility-focused activities.