Senior Parliamentarian visits Scotland’s Gift to the World on Healthy Ageing

The ROS calls for Public Audit of Fracture Liaison Services in Scotland to give Scots the same transparency on NHS performance as people are getting in England and Wales 

Pam Duncan Glancy MSP, Chair of the Cross-Party Group on Musculo-Skeletal Conditions (MSK) visited the Queen Elizabeth University Hospital in Glasgow today to learn about the world’s first Fracture Liaison Service (FLS).  

The FLS model is a Scottish-born success story which has changed the lives of millions of older people – particularly older women – across the world. Glasgow was its birthplace in 2001, when a pair of Scottish clinicians determined that they should find a way to stop people with osteoporosis suffering preventable repeat fractures (broken bones).  

Osteoporosis is one of the most urgent threats to people living well in later life, both in the UK and across the world. Half of women over 50 will suffer broken bones due to osteoporosis, and a fifth of men, with 300,000 Scots living with the disease today. Non-traumatic fractures (fragility fractures) are the fourth most consequential health condition, measured in years lost to disability and premature death.   

Hip fractures in particular, which affect 6,000 Scots every year, are one of the biggest killers, with a quarter of patients sadly dying within 12 months of suffering the injury.  

In 2001, Glasgow clinicians Stephen Gallacher and Alastair McLellan recognised that by checking patients over 50 who presented with a fracture for osteoporosis, and by treating those diagnosed, they could prevent future (potentially more serious) breaks. A scan can help diagnose osteoporosis, with strong therapies available for people found to be at high fracture risk, to keep their bones strong. This ‘Fracture Liaison Service’ model was so successful that it was copied across the world - a proud and lasting contribution by Scottish clinicians to world health.  

Pam Duncan Glancy MSP chairs the Parliamentary group committed to improving treatment of MSK conditions. Ms Duncan Glancy joined Craig Jones, CEO of the Royal Osteoporosis Society, to visit the first FLS and learn more about how it is transforming and saving lives. During the visit, the group met senior clinicians and patients, while discussing the barriers to treatment that people in Scotland – and across the UK – sadly continue to face. 

Chair of the Scottish Parliament Cross-Party Group on MSK Conditions, said: 

“I was delighted to visit this world leading service in Glasgow and see first-hand the incredible work they do. 

“As someone who has had Juvenile Chronic Arthritis since I was a baby, I know the importance of bone health. Having clinics like these is essential to protecting the many people living with Osteoporosis or at risk of it, and I’m proud that Glasgow was the birthplace of this work.” 

The ROS has warned that, while on paper everyone in Scotland has access to an FLS, the absence of a Public Audit on the performance of the services is masking serious, risky gaps in quality and standards. These are leading to thousands of missed opportunities to prevent life-changing fractures, with a postcode lottery in Scotland for who gets access to therapies. People who live in an area with an under-performing FLS risk being overlooked and left to suffer further, potentially even more serious, fractures.  

Last year, the Scottish Government’s National Audit Programme Board decided that a Public Audit of Scottish FLS was required to allow Scots to hold their Health Boards to account for where services were failing – and also to help services understand the gaps in their own quality and improve standards. The Public Audit would cost merely £150,000 per year, which is only 0.15% of the Scottish spend on hip fractures, hundreds of which could be prevented by the public register. 

If the Public Audit had been delivered on the day the committee decided it was needed, we’d today be on course to prevent 172 hip fractures in Scotland by mid-2024. This would have saved the Scottish NHS a total of £4.5m (a return on investment of 15:1). Most sensitively, we’d be on course to prevent 43 deaths in Scotland. But since officials have not yet made any progress in finding the £150,000 needed for the audit, none of these benefits can yet be realised.  

In 2022, 23 MSPs signed a motion in the Scottish Parliament calling for a Public Audit.  

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

“Scotland has one of the proudest records of any country for osteoporosis care, since it was the birthplace of the world standard for fracture prevention.   

“It’s a bitter irony that in Scotland, of all places, and unlike in England and Wales, members of the public are being prevented from seeing how their Fracture Liaison Services are performing. Holding services accountable through published performance data will raise standards and prevent life-threatening fractures.   

“We hope the Scottish Government will demonstrate its commitment to older people’s health by funding this audit its Audit Programme Board has cited as being necessary”.