Share your experiences to help inform system change in fracture prevention services

New analysis from the Royal Osteoporosis Society (ROS) highlights a postcode lottery for Fracture Liaison Services (FLS) across the UK.

The new All-Party Parliamentary Group (APPG) on Osteoporosis and Bone Health is keen to hear from health professionals in a Call for Evidence, aiming to level up services across the country.

New analysis of fracture prevention services
While everyone in Scotland and Northern Ireland has access to a FLS, only 57% of the population in England is covered, and only 72% in Wales. This leaves thousands of people who are at high risk of follow-on fractures without the care and treatment they need to avoid painful broken bones, causing mounting costs for the NHS.

Today’s new analysis compares standards in different areas of the country to draw out inequalities in access. Yorkshire, Merseyside and London are regions with insufficient access to FLSs: six hospitals in Yorkshire; six in Merseyside and five in London do not have a FLS. If everyone living in just these three regions alone had access to a FLS, it would save the NHS £6.8m per year and prevent over 4,000 broken bones over a five-year period.¹

Even living the wrong side of a city can markedly increase a person’s risk of re-fracturing, due to lack of access to a FLS. The quality of these services also varies wildly across different regions.

People who have had a fracture due to osteoporosis are at heightened risk of suffering painful follow-on fractures, unless they’re identified and where appropriate moved onto anti-osteoporosis medication. Alarmingly, a fifth of women who have broken a bone, break three or more before even being diagnosed.

Up-scaling FLS provision to cover everyone age 50 and over in the UK could prevent 5,686 fragility fractures every year saving £65.7m in fracture-related costs annually.²

Craig Jones, Chief Executive at the ROS says,

“Too many people are living with the pain of avoidable fractures before they’re finally diagnosed with osteoporosis and moved onto treatment, after which they can live a perfectly ordinary life. This new analysis shows the scale of the postcode lottery people face in getting the treatment they deserve.

“It’s a bitter irony since Fracture Liaison Services were invented in the UK, before being exported to numerous other health systems across the world. These services work, they’re a lifeline for avoiding severe pain and disability, and they save the NHS millions.”

Call for Evidence
The All-Party Parliamentary Group (APPG) on Osteoporosis and Bone Health was launched by MPs and Peers in March to raise awareness of the condition and the importance of bone health among Parliamentarians and NHS leaders. Its first act is to launch an Inquiry into the postcode lottery for access to a quality FLS.

The ROS, who acts as the secretariat for the APPG, are keen to hear from a range of healthcare professionals who are working with patients who have already fractured or are at risk of fractures. These anonymous, personal experiences will inform the APPG Inquiry into how to improve FLSs.

Email your experiences to appg@theros.org.uk or write to us at FLS, Royal Osteoporosis Society, St James House, The Square, Lower Bristol Road, Bath, BA2 3BH. More information can be found at: theros.org.uk/appg.

The deadline for sharing experiences is 18 June 2021.

References

1 The analysis was done for regions that ROS experts in the field have highlighted and was based on calculations using the ROSs benefits calculator that uses population data. ROS also cross referenced the areas using the FLS Database, held by the Royal College of Physicians, to determine which hospitals are not currently submitting performance data, suggesting that they do not have a FLS. Local analyses were carried out and the topline results were:
• Yorkshire – six hospitals do not have FLS. If all hospitals in this area had FLSs, the NHS could save £2.8m per year and prevent 1,667 broken bones over a five-year period
• Merseyside – six hospitals do not have FLS. If all hospitals in this area had FLSs, the NHS could save £2.2m per year and prevent 1,331 broken bones over a five-year period
• London - five hospitals do not have FLS. If all hospitals in this area had FLSs, the NHS could save £1.8m per year and prevent 1,009 broken bones over a five-year period.

2 Fragility fractures in Europe: burden, management and opportunities. Fredrik Borgström et al 2018