1,400 lives set to be needlessly lost this year following Government inaction on Osteoporosis

The Royal Osteoporosis Society has today (15 March 2024) set out the human, financial and economic impacts of the Treasury’s blocking of Ministers’ proposals for a transformation fund for Fracture Liaison Services (FLS). 

Half of women over 50 will suffer fractures because of osteoporosis, and a fifth of men. That’s every other mother, every other grandmother. 

Fractures are the fourth worst cause of disability and premature death, and the second biggest filler of hospital beds. Fractures are preventable with safe, effective medications that are highly affordable for the NHS. But 90,000 people every year are missing treatment because of the absence of FLS in half of NHS Trusts.

FLS diagnose people after the first fracture, so they can get access to bone-strengthening drugs and prevent life-limiting fractures. These services are the world standard for care, available in 55 countries, but the UK has fallen way behind, resulting in two-thirds of people with osteoporosis missing treatment. The result is a revolving door of fracture patients in Britain’s hospitals.

Today, ROS has set out the ledger of misery for osteoporosis patients in the time between now and the next Budget (expected in March 2025).  Due to the missed opportunity to make FLS universal, over the next year we’ll see:

Ledger of misery

• 10,000 preventable fractures
• 4,200 preventable hip fractures that will kill 1,400 people within a year
• £39m of wasted costs in the NHS and social care fixing fractures which could have been prevented
• 105,000 bed days unnecessarily taken up in the NHS
• 650,000 sick days that could have been prevented by FLS

Over the same period, 27,000 working people with osteoporosis will be forced out of jobs, many of whom could have been protected by early access to medication through FLS.

With only three new FLSs set up last year, under NHS England’s current rate of progress, it will take until 2048 to close the eye-watering treatment gap for osteoporosis. 

In some areas, we’re going backwards. News broke this week that the Nottinghamshire FLS will close due to the Integrated Care Board (ICB) having overspent its general budget. According to an ICB official, the local FLS will pay the price because FLS is “best practice rather than a mandated service.”

Former First Secretary of State Rt Hon Damian Green MP said:

“This is a very disappointing outcome as Health Ministers have agreed the 90,000 people missing treatment is causing great harm and that Fracture Liaison Services are the solution. But we’ve now missed another opportunity for a cross-government resolution that can lead to the change that people urgently need.  We’ll continue to see 2,000 preventable deaths every year without early intervention, while the costs for social care and the NHS spiral further as the population ages. I urge all parties here to get round the table and find a way to get the proposals over the line”.

Former Home Secretary Rt Hon David Blunkett said:

“Logically the Treasury should opt for measures to reduce demand on public services and boost the labour market. By doing nothing to prevent fractures, Ministers have chosen the most expensive option, since tens of thousands of people will continue to need hospital treatment for multiple fractures before they finally get a diagnosis. Many of those people will be working people in their fifties and sixties, who will be forced into extended sick leave and early retirement due to the pain of preventable injuries. I hope the Government will reconsider this simple, common sense intervention over the coming months.”

Craig Jones, Chief Executive of the Royal Osteoporosis Society said:

“The Government has repeatedly pledged action on osteoporosis – a disease which shatters the lives and careers of tens of thousands of middle-aged women. Every other mother, every other grandmother, will suffer. 

Ministers know there’s immense suffering and wasted potential, which can be easily alleviated by existing medications. But so far they’ve chosen to look away and do nothing. 

We call on Ministers to give the forthcoming Major Conditions Strategy teeth.  Without a Transformation Fund for fracture services attached to it, this won’t be a credible document, and we’ll continue to see critical preventative services like the Nottinghamshire FLS close down because Ministers are sitting on their hands.”

Dr Ian Higginson, Vice-President of the Royal College of Emergency Medicine said:

“Fractures related to osteoporosis are a common reason for patients to attend our Emergency Departments. Many such patients are frail and at risk of further falls and injuries. Interventions designed to reduce the risk of future events make sense to Emergency Medicine clinicians, who really understand that prevention is a better option that a visit to one of our departments.”

Ministers have, on numerous occasions, pledged to act to extend FLS to the half of Trusts where they’re absent – places where a catchment line makes the difference between peaceful independence and a life-threatening hip fracture. Broken promises include:

• Women’s Health Minister Maria Caulfield committed in August 2023 that the Government “will explore setting up more FLS and say more later in the year”; nothing more was said.
• Health Minister Lord Evans promised in September 2023 that the Autumn Statement would include a “package” on FLS, but withdrew the pledge the next day, saying he “misspoke”.
• The Government apologised in January after letters sent to constituents misleadingly claimed FLS had already been funded in the Elective Recovery Plan. 

Extending access to FLS through a temporary Transformation Fund will save £440m in NHS costs over the next five years, by preventing 50,000 fractures.  Over 21,000 life-threatening hip fractures will be prevented over the same period, saving 7,000 lives.  ROS’s calls to relieve NHS burdens through FLS have been endorsed by the Presidents of seven Royal Medical Colleges and 43 charities. 

The call to act on FLS has also been endorsed by a range of business leaders and trade unions, since 81,000 working age people suffer fractures every year. A third of those people (27,000) are forced out of their jobs, with a further 2.6m sick days handicapping businesses every year.

The CBI, Federation of Small Businesses, British Chambers of Commerce, British Retail Consortium, Business in the Community, UK Hospitality, Small Business Britain, the Trades Union Congress, Unite and GMB union have all called for action on FLS.

A growing list of 270 Parliamentarians have demanded action to give everyone over 50 access to an FLS.  Women’s health organisations including Mumsnet, the British Menopause Society and Wellbeing of Women have highlighted the urgency of osteoporosis as a women’s health priority.

To find out more about the campaign, visit our campaign with us page.