All-Party Parliamentary Group launches Inquiry into Primary Care for people with osteoporosis

The All-Party Parliamentary Group for Osteoporosis and Bone Health (APPG) is today launching an Inquiry into primary care for people with osteoporosis. Expert witnesses, people with osteoporosis and other stakeholders are encouraged to submit written evidence to the inquiry. 

If you have your own lived experience of osteoporosis, or you wish to submit evidence on behalf of someone with the condition, you can take our short APPG Primary Care Survey.

The inquiry launched today is the second act of the APPG, following the successful Inquiry into Fracture Liaison Services (FLS) – the gold standard for systematically identifying, accessing, and treating anyone who breaks a bone after age 50 last year.

In this first inquiry the APPG heard experiences from patients who had to prompt their own assessment for osteoporosis. They also heard about a lack of expertise in some primary care settings that left some patients feeling unsupported and unsure about how to manage their condition. The Royal Osteoporosis Society (ROS) reaffirmed these findings in their Life with Osteoporosis report last year, which found:

• Almost half of people (46%) were dissatisfied with the level of monitoring they were receiving from the NHS.
• Only half (54%) of people feel confident about managingtheir osteoporosis

The Inquiry into primary care launched today will be looking at primary care provision (including GPs, practice nurses, community and clinical pharmacists and associate physicians) and seeks to identify the barriers to the provision of high-quality care for patients. The APPG will explore the best ways to tackle the challenge of osteoporosis, prevent fractures and improve the lives of people with the condition.

Primary care professionals have a responsibility to appropriately identify, treat and monitor people with osteoporosis.  Currently, the postcode lottery for osteoporosis care is leaving two-thirds of people with spinal fractures – up to 2.2m people undiagnosed.

The APPG welcomes evidence addressing the following questions:

• What actions are primary care providers and commissioners taking to identify the population who are at high risk of an osteoporotic fragility fracture?
• To what extent is osteoporosis seen as a healthcare priority, requiring proactive prevention and/or treatment?
• What fracture risk assessment tools (e.g. FRAX^®, QFracture^®) are currently used to identify patients at risk of fracture and what barriers are there to identifying all patients at high risk of an osteoporotic fragility fracture?
• Who, in primary care, is best placed to deliver care for people with osteoporosis? This includes identification, interpretation of results, treatment, monitoring and medication reviews.
• Do clinicians in primary care have adequate and timely access to tests used in the diagnosis, investigation and monitoring of people at high risk of fracture, e.g. DXA scans, biochemical markers of bone turnover?
• What education and training in osteoporosis is offered to primary care professionals – including fracture risk assessment, interpretation of DXA results, treatment and monitoring of osteoporosis patients?
• What actions are being taken to optimise adherence to treatment by patients with osteoporosis, and what barriers are there to effective monitoring?
• How readily can clinicians in primary care access injectable treatment (eg IV zoledronate, SC denosumab) for those patients unable to take or tolerate oral bisphosphonates?
• What inter-relationships between medical and social care practitioners, are needed to effectively identify, treat and monitor patients with osteoporosis?
• How effective are current financial incentives (such as the Quality and Outcomes Framework, Quality Assurance and Improvement Framework and the Additional Roles Reimbursement Scheme) in achieving sustainable, comprehensive and high-quality care for people with osteoporosis?
• What national, regional, and local levers would help to improve primary care provision for people with osteoporosis?

If you’d like to submit evidence to the Inquiry, you can do this electronically by emailing appg@theros.org.uk or in writing to: Primary Care Inquiry, Royal Osteoporosis Society, St James House, The Square, Lower Bristol Road, Bath, BA2 3BH. 

The deadline for the receipt of written evidence is 5pm 24 April 2022.   

In addition to this call for written evidence, the APPG will be taking oral evidence from public officials, leading clinicians and patient advocates.