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Aims and Objectives This project aimed to implement PoCUS for diagnosing neck of femur (NOF) fractures in a large inner-city Emergency Department (ED), with the primary outcome of reducing the time to diagnosis.Method and Design A multidisciplinary team reviewed clinical guidelines, consulted stakeholders, and revised procedures for patients with NOF fractures. A literature review confirmed ultrasound diagnostic accuracy for NOF fractures, leading to a stakeholder-approved PoCUS trial in the ED.Initially, sixteen clinicians of varied qualifications were trained using a standardised, repeatable training program. 58 scans were completed within the three-month data collection period. Standardised documentation templates were introduced for structured data collection, and a single portable handheld device was used to streamline patient data recording and to standardise governance.A post-intervention audit evaluated the time to imaging, departmental length of stay, and ultrasound diagnostic sensitivity and specificity.Results and Conclusion The introduction of PoCUS led to faster diagnosis times and Fascia Iliaca Compartment Block completion. Patients who underwent PoCUS diagnosis were admitted to an orthopaedic ward, on average, two hours quicker than those diagnosed with X-ray alone. The sensitivity and specificity across three months was 100% for 58 scans. Across twelve months, sensitivity was 97% and specificity was 92% for over 120 scans by twenty clinicians of varying grades and qualifications.Implementing PoCUS for diagnosing neck of femur NOF fractures in ED has demonstrated substantial improvements in diagnostic efficiencyand patient care. This project reduced the time from booking in to admission by facilitating quicker diagnoses and timely FICB. The post-intervention results evidenced that patients diagnosed via ultrasound were admitted to orthopaedic wards faster than those without. The ultrasound also exhibited diagnostic accuracy, with a sensitivity of 97%. By integrating PoCUS into diagnostic protocols, the multidisciplinary team has enhanced resource utilisation, decreased waiting times, and improved overall patient care, reducing morbidity and mortality rates.