Alarm raised by proposal to axe “life-saving” Fracture Liaison Service, which will “shatter the lives of Nottinghamshire residents”

Decision to end local service due to “lack of Government mandate” shows the desperate need for action from Central Government

Local residents and healthcare professionals are today (21 March 2024) batting to reverse a decision to close the Fracture Liaison Service (FLS) in Nottinghamshire. For 14 years, the local FLS has helped ensure 3,000 people annually get an early osteoporosis diagnosis and access to preventative drugs, so life-changing hip and spinal fractures can be prevented. 

With broken hips killing a third of sufferers within a year, the service has been described as “life-saving” by the Royal Osteoporosis Society.

Officials from the local Integrated Care Board (ICB) – the commissioning body – say the proposal to axe the service is owed to the lack of a mandate from central Government for FLS and the need to reduce costs in the face of financial difficulties. 

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

Broken bones caused by osteoporosis are the fourth worst cause of disability and premature death, and the second biggest filler of hospital beds. Broken bones 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 behind. The result is a revolving door of fracture patients in Britain’s hospitals and over 2,000 preventable deaths every year.

Nottinghamshire already has inadequate, patchy coverage of FLS, with data from ROS showing there will be over 1,300 preventable fractures suffered by local residents over the next five years.  Over 550 of these injuries will be life-threatening broken hips, which will lead to over 180 people dying early. If Nottinghamshire had FLS which covered everyone over 50, the ICB could save £15m over the next five years and release over 13,000 bed days in local hospitals. 

This decision, unless altered, would represent another step backwards and increase these local costs steeply. 

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

“Nottinghamshire residents are already being let down by a brutal postcode lottery for osteoporosis services. This is costing older patients their independence and sometimes their lives. If local commissioners axe one of the few services remaining, they’ll abandon patients to thousands of broken bones and shattered lives. The inevitable result will be a revolving door of fracture patients in local hospitals that will cost the NHS vastly more. Every other mother and every other grandmother in Nottinghamshire will be affected by this reckless decision. 

“Nothing could show more clearly to Ministers in Whitehall the desperate need for a mandate for FLS. Without it, we’re sliding backwards and storing up a tsunami of broken bones.”

Over 270 Parliamentarians have supported the call for everyone over 50 – wherever they live in the country – to have access to a high-quality FLS. The call has also been supported by the Presidents of seven Royal Medical Colleges, the British Medical Association, a range of social care providers and 43 charities, including Mumsnet.

Lindsey Wallis, Chair of the Nottinghamshire Osteoporosis Group said:

“The Fracture Liaison Service in Nottinghamshire has been a life changing service for patients with osteoporosis. Fracture patients were seen and treated with great efficiency in their own homes. Many patients with fractures suffer crippling pain and simply can't travel to hospital for their medications. Removing this service will result in lives ruined and lost. It will cause far greater cost pressures on the local hospitals.”

Dr Anne-Marie Stewart, lead at the Nottinghamshire FLS said:

“It’s heartbreaking to think of the amount of expertise we have developed since the inception of this service almost 14 years ago, which will now all be lost.”