Key Info

The COVID-19 pandemic has precipitated the rapid development and evolution of virtual fracture clinics (VFCs) nationally due to necessities of safe hospital distancing. The shift to virtual clinics is advocated by the British Orthopaedic Association (BOA) in the recently published COVID-19 BOAST guidelines. There is however a paucity of evidence reporting the outcomes of patients with injuries safely managed in a VFC with no further face-to-face assessment.

Primary Aim

Assess the impact of the COVID-19 pandemic and the consequent BOAST guidelines on patient satisfaction and clinical outcome following VFC assessment.

Secondary Aims

Determine the impact of the pandemic on variation in practice, patient demographics and the nature of injuries presenting to the VFC, including number of injuries, nature and injury type; and to compare satisfaction and clinical outcomes of VFC assessment when the BOAST guidelines were first introduced to a period during the ‘second wave’ where local practice would be familiar with such guidelines.

Inclusion criteria

  • Adult patients (≥ 18 years) managed at a virtual fracture clinic (VFC) in the UK
  • All consecutive patients managed in a participating VFC during 6 May 2019 to 19 May 2019 and from 4 May 2020 to 17 May 2020 (MAVCOV 1)
  • A random sample of patients discharged from a participating VFC during the ‘second wave’ of the pandemic in October 2020 (MAVCOV 2)


Individual hospital teams comprising trainees, medical students and a supervising consultant.

Data collection

Local data collected for this audit will need to be anonymised and de-identified before submission using the MAVCOV Data Collection Tool. A telephone questionnaire should be administered for patients who have been discharged from the VFC.


This study is registered as a clinical audit at participating hospitials. The study protocol has been reviewed by the South East Scotland Research Ethics Service and is classified as a multi-centre audit.


Participation in this project results in collaborative authorship on all primary publications, with a PubMed citable ID attributed to all collaborators.

Project documentation

Please see the MAVCOV Project Documentation Hub for more details.


Please submit all queries to


MAVCOV Protocol has been published in the Bone & Joint Open.

MAVCOV 1 results will be sent to each centre in March 2021.

Following the success of MAVCOV 1, we would like to invite you to participate in MAVCOV 2, which involves collecting data for an additional sample of patients seen in your centre in October 2020.

This is to compare satisfaction and clinical outcomes of VFC assessment when the BOAST guidelines were first introduced to a period during the ‘second wave’ where local practice would be familiar with such guidelines.

This can be completed by the original team, or you can invite an additional researcher to be involved for this stage. If you are interested in MAVCOV 2, or know a colleague who might be, please email us by 21 May 2021.

The completed MAVCOV 2 Audit Data Collection Tool should be submitted to the MAVCOV Steering Committee by 20 June 2021 .
Any requests to extend the deadline for data submission should be sent to and will be reviewed on a case-by-case basis.

Participating virtual fracture clinics


North East

  • Northumbria Specialist Emergency Care Hospital
  • James Cook University Hospital
  • South Tyneside District Hospital
  • Sunderland Royal Hospital

North West

  • Manchester Royal Infirmary
  • Royal Bolton Hospital
  • Chorley and South Ribble Hospital / Royal Preston Hospital
  • Fairfield General Hospital / North Manchester General Hospital / Rochdale Infirmary / Royal Oldham Hospital
  • Salford Royal Hospital
  • Wythenshawe Hospital
  • Cumberland Infirmary


  • Huddersfield Royal Infirmary
  • Leeds General Infirmary

East Midlands

  • Queens Hospital, Burton
  • Leicester Royal Infirmary
  • Kettering General Hospital

West Midlands

  • Sandwell Hospital
  • Walsall Manor Hospital

East of England

  • Basildon & Thurrock University Hospital
  • Addenbrookes Hospital
  • James Paget University Hospital

Thames Valley

  • Milton Keynes General Hospital
  • Royal Berkshire Hospital

North West London

  • St Mary’s Hospital
  • Charing Cross Hospital
  • Ealing Hospital
  • Chelsea & Westminister Hospital
  • West Middlesex University Hospital

North Central/East London

  • Royal London Hospital
  • Royal Free Hospital
  • Whittington Hospital
  • Queen’s Hospital, Romford
  • Barnet Hospital

South London

  • Kings College Hospital

Kent, Surrey, Sussex

  • St. Peter’s Hospital
  • Royal Sussex County Hospital
  • Medway Maritime Hospital
  • William Harvey Hospital Ashford


  • Queen Alexandra Hospital
  • Salisbury District Hospital

South West

  • Gloucester Royal Hospital
  • Royal Cornwall Hospital
  • Musgrove Park Hospital
  • Great Western Hospital


  • Royal Infirmary of Edinburgh
  • Ninewells Hospital
  • Perth Royal Infimary
  • Monklands District General Hospital
  • Victoria Hospital, Kirkcaldy
  • Aberdeen Royal Infirmary
  • Glasgow Royal Infirmary
  • Queen Elizabeth University Hospital
  • Raigmore Hospital


  • University Hospital of Wales Cardiff

Northern Ireland

  • Royal Victoria Hospital Belfast
  • Ulster Hospital