Purpose: The national Hip Sprint audit highlighted poor mobility outcomes following neck-of-femur fractures (NOF#) with up to 60% failing to return to pre-fracture mobility level. The standard community rehabilitation provided by our Trust included long waits and basic levels of rehabilitation provision. Our elective arthroplasty pathway incorporates a specialist orthopaedic home-support-team (HST) whom visit patients in their homes after in-patient discharge to provide rehabilitation and joint management. COVID-19 placed unprecedented demands on inpatient bed capacity and community service provision with the need to prevent long length of stay. Whilst elective orthopaedics ceased during the second wave, our aim was to determine if early specialist community intervention following NOF# results in low length of stay and provides clinically significant improvements in patient outcomes. Methods: We performed a two-month pilot study (December–January 2020/21) for all NOF# cases at an NHS district general hospital. The inclusion criteria for specialist HST involvement were the capacity to follow commands, absence of complex social-care needs and the ability to step-round transfer with/without equipment. Outcome measures were time to first contact, number of contacts, Berg Balance score, mobility status, ongoing referral requirement and patient subjective feedback (iWantGreatCare: questions 7,81,97,98). Results: There were 73 NOF# cases occurring across the 2-month study period with 23 (32%) cases meeting the inclusion criteria for specialist HST. Eight patients (11%) passed away during the pilot period, one was seen by the HST. One case seen by the HST ultimately required revision-surgery. The mean age of cases seen by the HST was 78 years (range 51–96). Surgical management comprised of hemi-arthroplasty (8), intramedullary-nail (6), total hip arthroplasty (6), and dynamic hip screw (3). The mean length of inpatient stay was 8 days (range 1–33) with all patients returning to their usual place of residence. All patients’ received telephone contact within 24-hours and the medium time to first community contact was 4 days, with patients receiving on average 3 visits (range 1–8) over a mean 21 days. Over 80% (17/21) of patient improved their mobility status from inpatient discharge to HST discharge (mean 20 days). Within 3-months of surgery, 15 cases returned to their pre-fracture level of mobility, including 8 who are mobilising independently. The Berg Balance score was completed in 14 patients with 11 achieving a clinically significant change (>6.5). Thirteen patients did not require any further healthcare input and four were able to be managed in an out-patient setting. Patient reported outcomes showed 100% patients scored 5/5 on all questions. Conclusion(s): A third of NOF# cases were eligible for the HST service. We have demonstrated specialist HST involvement achieves significant improvements in balance and mobility with high levels of patient satisfaction. In one case, a patient who sustained a NOF# a year previous and a second during this pilot managed to return to primary pre-injury mobility with the assistance of the HST, despite failing to achieve this after their first injury. Impact: Utilising a specialist orthopaedic HST may reduce the strain of inpatient capacity and traditional community rehabilitation services however further investigation is required.