Patients with broken hips in parts of the Westcountry suffer with pain while they face some of the longest waits in the country for replacement surgery.

Derriford Hospital has been rated among the bottom three by the Royal College of Surgeons, in an audit which found that only 57 per cent of elderly hip casualties had replacements within 48 hours.

The annual audit of hospitals in England, Wales and Northern Ireland covered April 2009 to March 2010. At Derriford, it looked at 426 patients in their 70s, 80s and 90s.

Derriford said there had been a marked improvement since the audit.

Elsewhere in the Westcountry, other hospital trusts fared better. North Devon did not provide enough data to be included, but at the Royal Cornwall Hospital Trust, more than three quarters of patients were seen within 48 hours, and at the Royal Devon and Exeter it was more than 80 per cent.

But all the figures lag behind the best performers – at Wansbeck Hospital in Northumbria, 95 per cent of elderly patients through surgery in 48 hours.

Colin Currie, a consultant geriatrician who helped compile the data, said there was "no excuse" for the poor care being seen in some hospitals.

"The human cost of hip fracture is enormous, and poor quality care can result in patients enduring avoidable pain, disability and even – worst of all – the loss of home and independence," he said.

"Cost and quality of care are not in conflict because looking after hip fracture patients well is far cheaper than looking after them badly. So there is now absolutely no excuse for the sub-standard care that we are still seeing in some hospitals."

A Plymouth Hospitals NHS Trust spokesperson said: "Between April and June 2010, 77 per cent of our patients with hip fractures received their operation within 48 hours. This is a marked improvement on last year. In July and August 2010, 84 per cent and 85 per cent of patients received their surgery within 48 hours.

"We have increased the number of staff dedicated to the care of patients with hip fractures, which includes consultants and specialised physiotherapists."