House of Lords debate demands urgent action on Fracture Liaison Service coverage and gives voice to millions with undiagnosed fractures

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15 Sep 2023

In a powerful and impassioned debate held in the House of Lords on September 14th, Peers discussed the urgent need to enhance access to and quality of services for individuals suffering from osteoporosis and those at risk of fractures.  

The focus of the debate revolved around the critical role of Fracture Liaison Services (FLS) as the world standard in secondary fracture prevention and the need for the Government to take decisive action to achieve universal FLS coverage. 

Bold Leadership for Fracture Prevention 

Lord Black of Brentwood opened the debate by highlighting the severity of the current situation, referring to it as a "public health crisis." He underscored the grim reality that osteoporosis-related fractures claim as many lives as lung cancer or diabetes, emphasising that fractures rank as the second-highest cause of bed occupancy within the NHS. Additionally, fractures result in a staggering 2.62 million sick days each year in the UK. Lord Black urged the government to demonstrate "bold, visionary leadership" on FLS to improve the lives of tens of thousands of people. 

Baroness Chisholm of Owlpen called for greater national leadership in osteoporosis and fracture prevention within NHS England, advocating for the appointment of a National Clinical Director or, at the very least, a National Specialty Advisor for osteoporosis. Baroness Donaghy criticised the government for overlooking osteoporosis in the Women's Health Strategy, pointing out that the condition was mentioned only 12 times in the document. 

Baroness Hayter of Kentish Town highlighted Wales as a role model for England, citing its Ministerial Mandate for 100% population coverage of FLS by September 2024.  

Government Response

In response to the debate, Lord Evans of Rainow, speaking on behalf of the government, acknowledged that in the UK, 3 million people suffer from osteoporosis, resulting in 500,000 fragility fractures annually and causing 2.6 million sick days each year. 

Lord Evans endorsed the idea of a Fracture Tsar, a specialist clinical lead within NHS England dedicated to taking FLS coverage from 51% of Trusts to 100%. 

The Royal Osteoporosis Society's Response 

Responding Craig Jones, CEO of the Royal Osteoporosis Society, said:  

“I want to thank Peers for the extremely strong debate this evening, where they captured perfectly the case for Fracture Liaison Services, and why early intervention to prevent fractures is a no-brainer for the NHS and the economy.   

Peers gave voice, in particular, to the millions of people with undiagnosed fractures in their spine.  So many of those people are younger, in their fifties and sixties, and get forced to reduce their hours at work or retire early, often causing serious financial problems.  

We welcome the Minister’s endorsement of the need for a Tsar for Fracture Prevention, which I now hope will be acted upon urgently by NHS England. The Royal Osteoporosis Society stands ready to financially support this role, if needed to get things over the line. 

Without Government leadership through a national mandate for FLS, we’ll continue to see preventable fractures flooding into our NHS, with all the pain and misery they inflict.  We’re calling on Ministers to take decisive action” 

A full recording of the debate is available here, a full transcript of the debate can be found here. 

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