England 'Flatlining' on Osteoporosis Care, New Analysis Warns

New official figures show England is “flatlining” on osteoporosis diagnosis.

There has been an alarming lag in improvement to diagnosis and treatment of osteoporosis – potentially leading to more than 40,000 preventable deaths, the Royal Osteoporosis Society estimate.

146,000 patients are due to suffer a preventable hip fracture – with over a quarter dying within a year – because of a lack of improvement to NHS fracture services.

Progress on expanding Fracture Liaison Services (FLS) across England has stalled, despite repeated Government commitments to ensure nationwide access by 2030. The ROS warns that, at the current rate of progress, the pledge may not be fully delivered until 2064.

Fracture Liaison Services help identify people at risk of osteoporosis following a fracture, enabling them to receive diagnosis, treatment and ongoing monitoring to prevent further, potentially life-threatening injuries. The services are widely regarded as the international gold standard for osteoporosis care.

Slow Progress Raises Concerns

Data from the national Fracture Liaison Service audit shows that 79,553 patients were identified through FLS services in England in 2025, compared with 77,136 in 2024 – an increase of just 3%.

However, analysis by the ROS suggests that around 264,000 people a year need to be identified through these services to ensure all eligible patients receive appropriate care. With approximately 184,000 additional patients still needing access by 2030, the charity says current progress falls significantly short of what is required.

The organisation estimates that continuing at the present pace could result in:

• More than 4.3 million fragility fractures being missed.

• Around 146,000 preventable hip fractures.

• Over 41,000 preventable deaths, based on the mortality rate following a hip fracture.

Impact of Osteoporosis

Osteoporosis causes bones to become weaker and more susceptible to breaking, often after a minor fall or even everyday actions such as coughing or sneezing. The condition affects an estimated 3.5 million people in the UK and causes around 500,000 fractures every year.

The condition particularly affects older adults. Around half of women over 50 and one in five men over 50 are expected to experience fractures linked to osteoporosis during their lifetime.

Despite the availability of effective and low-cost treatments, the ROS says many people remain undiagnosed because access to FLS services varies significantly depending on where they live. Currently, around half of NHS trusts in England do not have a Fracture Liaison Service in place.

Wales Shows What's Possible

While England's progress has been described as "flatlining", Wales has seen significant improvements following targeted investment and ministerial backing. Audit figures show the number of patients receiving FLS care in Wales increased from 5,485 in 2024 to 10,249 in 2025, almost doubling in a single year.

The ROS says this demonstrates how rapid expansion of osteoporosis services can be achieved when supported by clear implementation plans and funding.

Call for Action

Craig Jones, Chief Executive of the Royal Osteoporosis Society, said the latest figures should act as a wake-up call for policymakers.

"Today's figures show England is flatlining on osteoporosis diagnosis. Ministers in Whitehall owe it to people to be honest about whether and how they are going to implement their promise to roll out these clinics to every area.

"At the current pace, we won't see this pledge fulfilled until 2064 – eight general elections' time. Ministers have promised this rollout 85 times, but a pledge on paper saves no lives at all."

“A new Health Secretary offers the chance to rescue this policy, turn this around and save lives. We’re calling on James Murray to publish an implementation plan before Parliament’s summer recess, so people in England can benefit from the same life-saving care now offered in Wales.”

The charity is calling on the Government to publish a clear implementation plan for nationwide FLS coverage, arguing that faster action could prevent thousands of fractures, help older people maintain their independence, and save lives.

Find out more about osteoporosis and assess your risk using the Great British Bone Check: https://thegreatbritishbonecheck.org.uk/risk