A system of payment by results exists for the management of hip fractures in England and Wales.UCLH performed badly in the 2013 national hip fracture database (NHFD) audit against the national standards.

Through the introduction of a multi-disciplinary patient pathway and clerking pro forma, the proportion of patients earning the best practice tariff uplift increased from 44.4% to 91.7%.

This demonstrated a significant improvement in patient care measured against the guidelines, and also resulted in a substantial revenue increase for the department.