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Antony Johansen

Professor Antony Johansen

Honorary Professor. Consultant Orthogeriatrician in the University Hospital of Wales

School of Medicine


Every year 80,000 people break their hip in the UK. Most are aged over 80 with multiple social, medical and psychiatric comorbidities. Despite the success of modern surgery and anaesthesia these lead to prolonged hospital stays, and the resulting dependency means this one condition incurs health and social care costs of over £1 billion each year in the UK.

I’ve helped to develop two key resources to help people in the UK and other countries understand and improve the care of these patients.

National Hip Fracture Database (NHFD)

  • - a discussion of the most recent report of the national clinical audit of hip fracture care in England, Wales and Northern Ireland, and of how clinical teams can use the nhfd website to identify aspects of care that need to be the focus for local quality improvement work 

Fragility Fracture Network (FFN) 









I have used lectures and interactive teaching to spearhead the development of the specialty of orthogeriatrics within my hospital, within wales, and across the uk. I have pioneered new approaches to the care of frail and older trauma patients, using hip fracture as a model with which to study and understand their needs, and so improve how health services respond to them.

I teach students, surgical and medical juniors and the multidisciplinary team within my hospital and my national and international lecturing aim to support the adoption of hip fracture audit and orthopaedic-geriatric collaboration in other countries.

Protocols for the assessment and management of patients are key to improving care and outcome. Much of my work has focused on the development of a clerking and 'care bundle' protocol for the initial care of my own patients with hip and other femoral fractures:

Hip fracture proforma 

The following series of youtube talks is designed as a resource for students, nurses, therapists and juniors joining my department and explains the approach taken in this cardiff clerking proforma. My talks are a free resource for people developing hip fracture service in countries where the incidence of this injury is rising, but where the specialties of orthogeriatrics and geriatric medicine are less well developed.

Hip fracture made simple

A quick introduction to key aspects of acute hip fracture care (15 minutes)

Orthogeriatrics talks

Using hip fracture to help us understand Frailty (28 minutes)

Using hip fracture to help us understand Peri-operative care (35 minutes)

Using hip fracture to help us understand Delirium (27 minutes)

Using hip fracture to help us understand Nutrition (19 minutes)

Using hip fracture to help us understand Falls (22 minutes)

Using hip fracture to help us understand Osteoporosis (19 minutes)



In the 1990s Professors Woodhouse and Bayer pioneered acute geriatrician support for the Cardiff Trauma Unit. Since 1994 I have developed this concept; working as a full-time NHS consultant since 1997.

I was the world’s first consultant ‘orthogeriatrician’ to work full time in the acute orthopaedic wards, and went on to establish this new specialty by co-authoring the key British Orthopaedic Association ‘Blue Book’ on care of people with fragility fractures, and the 2011 NICE guidelines on hip fracture.

Since 2013 I have led our national clinical audit of hip fracture – the National Hip Fracture Database (NHFD), and its national sprint audits of hip fracture in collaboration with the Association of Anaesthesia and with the Chartered Society of Physiotherapy.

The NHFD's innovative website makes a vast array of real time patient and service data freely available to those leading local and national quality improvement and research work in this area. The most recent NHFD report focuses on 2022 and is available at: and I discuss what the report and the NHFD website tell us in this YouTube talk: (27 minutes).