INTRODUCTION: Prior to the 2020 Association of Anaesthetists (AoA) guidance, there were no formal UK guidelines for the perioperative management of patients taking direct oral anticoagulants (DOACs) undergoing hip fracture surgery. This survey aimed to identify whether clinicians experienced difficulties when managing people who present to hospital on DOACs and require acute hip fracture surgery. METHODS: The survey was distributed to three clinical groups in the UK and Ireland: anaesthetists, geriatricians and orthopaedic surgeons. Associated networks (AoA, Fragility Fracture Network, British Geriatrics Society, British Orthopaedic Association) were contacted for wider distribution. Questions in the survey explored issues around perioperative management (e.g. frequency of delays to surgery and anticipated consequences of this) and required either an ordinal response or free text answers. Free text answers were analysed for common themes. RESULTS: In total, the survey analysed 125 eligible responses: 39% from anaesthetists, 43% from geriatricians and 18% from orthopaedic surgeons. The majority (83%) of the responses were from consultants. Most commonly, clinicians reported that patients "sometimes" experienced delays to surgery because of DOACs (45% of anaesthetists, 41% of geriatricians and 36% of orthopaedic surgeons). The commonly perceived consequences of delay were increased morbidity, length of stay and pain. Geriatricians felt that advice from associated specialties (haematology, anaesthesia and orthopaedic surgery) was variable. Clinicians did not observe an increased risk of bleeding complications in this cohort. CONCLUSIONS: This survey has highlighted that clinicians' experiences around the management of DOACs prior to acute hip fracture surgery are variable. This can be detrimental to the patient and cause greater morbidity. Consequently, standardised national DOAC advice to facilitate prompt surgery is needed and the 2020 AoA guidelines provide this. [ABSTRACT FROM AUTHOR]