Scottish Govt must now deliver a mandate for universal Fracture Liaison Services and set rigorous care quality standards – just like England and Wales
A failure to deliver high-quality Fracture Liaison Services (FLS) across Scotland is contributing to a devastating increase in broken hips, say campaigners.
FLS are early diagnosis services for osteoporosis, which is one of the top drivers of disability and early death amongst older people in Scotland.
Osteoporosis causes bones to weaken and break more easily – often just from a fall from standing height, a cough or a sneeze.
Half of women aged over 50 will suffer devastating broken bones as a result of osteoporosis, as well as a fifth of men. The end result of late treatment of osteoporosis is a life-threatening hip fracture, which kills over a quarter of sufferers within a year.
The number of people aged 50 and over who suffered hip fractures rose considerably in 2024 to 8,426* cases, a new report by Public Health Scotland shows.
The Royal Osteoporosis Society is now calling on the Scottish Government to deliver a mandate requiring all health boards to have high-quality Fracture Liaison Services (FLS). The Scottish Government must also set rigorous performance standards for FLSs to ensure enough patients are being identified, treated and monitored.
A mandate like this is already in place in England and Wales, leaving Scotland trailing behind, despite Glasgow being the birthplace of the FLS model, which has been copied in 57 countries.
Without a mandate from the Scottish Government, NHS chiefs are not incentivised to provide high-quality FLS in all areas. The lack of publicly available data – because a national audit of all FLSs has been delayed – is concealing life-threatening gaps where services are not present or performing.
Fracture Liaison Services are specialist NHS clinics that diagnose and treat osteoporosis in people over 50 after the first broken bone. Early detection and treatment – with inexpensive medication that is available on the NHS – is vital in preventing further fractures such as broken hips.
Currently, many patients in Scotland are not having their osteoporosis diagnosed and treated, which is leading to a devastating cascade of further avoidable fractures.
If Scotland had quality universal FLS coverage, over a five-year period, it is estimated:
8,899 fractures will be prevented – with 3,341 of those being hip fractures
60,000 acute bed days will be saved
£104m in all associated costs can be saved – including £64m in acute care costs
Craig Jones, Chief Executive of the Royal Osteoporosis Society, said: “In England and Wales, the governments have promised a national roll-out of life-saving bone clinics, but the Scottish Government has, so far, declined to match that commitment, saying an audit of current services is needed first.
“The slow pace of auditing services is fuelling the rise in life-threatening hip fractures, which will lead to lost lives. Scotland invented the world standard for fracture care, so it’s hugely disappointing to see the nation fall behind England and Wales.”
Carol Mochan, Shadow Minister for Women’s Health, said: “Every one of these hip fractures represents a person whose life has been turned upside down, and too many could have been prevented.
“The Government knows what we need – a mandate for universal, high-quality Fracture Liaison Services. Wales has done it. England is doing it. There’s no reason people in Scotland should be left behind.”
Dr Sandesh Gulhane, Shadow Cabinet Secretary for Health and Social Care, said: “Scotland led the world in creating Fracture Liaison Services, but that early lead has been squandered.
“Latest figures show that the number of people aged 50 and over with hip fractures has been rising, with the largest increases amongst people aged 70 to 89. This could be prevented by timely diagnosis and treatment, yet only 41.5% of patients in Scotland receive a full inpatient care package within 24 hours of admission.
“The rise in hip fractures is the inevitable result of this inaction. The promised audit remains unfinished, and without a mandate for quality services, patients will keep falling through the cracks. The Scottish Government must act now to put Scotland back at the forefront of osteoporosis care.”
Almost 200,000 people in Scotland are living with undiagnosed spinal fractures due to under-prioritisation of osteoporosis care.
Osteoporosis affects around 250,000 people in Scotland, and it’s estimated that 41,900 ‘fragility’ fractures occur here every year.
Fractures are the fourth worst cause of premature death and disability in Scotland.
Half of women over 50 and one fifth of men will break a bone due to osteoporosis, a condition where bones lose strength and break more easily – even from a cough, a sneeze or a hug.
Fractures are preventable with safe, effective medications that are highly affordable for NHS Scotland.
3.5 million people in the UK are estimated to have osteoporosis.
Osteoporosis causes 500,000 broken bones every year in the UK, costing over £4.5 billion.
The report by Public Health Scotland also shows standards of care in hospital for people following a hip fracture have plummeted. The average time patients spent in the emergency department after a hip fracture increased to 5 hours 36 minutes, compared with 5 hours 10 minutes in 2023.
The Welsh Government issued a mandate to deliver universal FLS, which has been achieved. Wales also published a Quality Statement for Osteoporosis and Bone Health, which committed to delivering quality standards of care for people with osteoporosis. Targets have been set to identify, treat and monitor more patients.
England has committed to rolling out universal FLS by 2030.
Potential spending is just ‘tip of iceberg’ of what can be achieved, says Scotland Loves Local chief
An extra £26.7m could be driven directly into Edinburgh’s economy if everyone in the city spent just £1-a-week more with local businesses.
The significant financial difference that can be made – safeguarding the future of businesses and protecting jobs – has been highlighted as part of Scotland Loves Local Week, which runs until Saturday (August 30).
The call to think local first is spearheaded by Scotland’s Towns Partnership (STP) – the organisation behind Scotland Loves Local – with support from the Scottish Government.
STP has calculated that, if every person in Scotland were to spend just £1 more per week with local businesses in their area, an additional £282.7m would be generated annually.
STP Chief Officer Kimberley Guthrie said: “The reality is that £26.7mm is the tip of the iceberg of what can be achieved in Edinburgh. If £1 more every week can make a transformational impact to the people who make our places, just imagine what is truly possible by choosing local even more.
“Money stays local for longer when you spend with local businesses.The multiplier effect is massive. These businesses spend with other businesses, who employ other local people, who then spend with other local businesses. Every penny spent is an investment in the future of your area.
“The jobs and livelihoods of your neighbours, friends and family depend on you doing so.”
STP champions the critical part that towns and local neighbourhoods play in creating a better Scotland and the need to invest in them.
Scotland Loves Local is the drive for people to build stronger, more sustainable futures for their community by supporting the businesses in their area.
Deputy First Minister Kate Forbes said: “Local spending is vital to the prosperity of our villages, towns and cities. It keeps people in jobs, businesses open and wealth in communities.
“The Scottish Government continues to work closely with Scotland’s Towns Partnership to drive forward the Scotland Loves Local campaign which aims to strengthen communities by putting localism and thriving town centres and high streets at the heart of a green, fair and growing economy.
“To create jobs and boost local economies we are also progressing our Community Wealth Building Bill which would, if passed by MSPs, encourage councils, NHS boards and other public bodies to buy more goods and services from their local businesses.”
Ticket sales up 11% on 2024 including significant rise in first time buyers
Footfall increased by 60% with 25,000 visitors in a single weekend
Library streaming service resounding success with 41 libraries in 12 local authorities tuning in, for free, for over 90 ‘watch parties’
Digital reach saw audiences in 63 countries, ranging from Japan to The Vatican, join online, expanding global audience reach
Female Scottish authors and independent publishers topped the Waterstones bestseller lists, alongside event led hits like Katabasis by R. F. Kuang and Nicola Sturgeon’s memoir, Frankly
New Kids’ Zone gets seal of approval from thousands of young people and families, with Princess the Unicorn, Bunny Vs Monkey, Supertato and Pikachu inspiring future generations of readers
This year’s children’s programme featured multiple sold-out events and a world premiere from Julia Donaldson’s Paper Chase.
Edinburgh International Book Festival has wrapped up a landmark year, celebrating a two-week long ‘Repair’ themed programme of events for all ages and interests, that saw conversations of global significance take place on stage, and connected with existing audiences while welcoming a whole new generation of readers.
The 2025 festival, which hosted over 650 authors and nearly 700 events saw a remarkable 11% increase in ticket sales over the previous year, with record numbers of people enjoying the vibrant atmosphere.
The festival’s new home at EFI proved a major draw with the courtyard welcoming over 25,000 visitors in a single weekend and a whopping 161,889 people in total, an increase of 60% compared to 2024, an unquestionable sign it’s settled into its new, permanent home.
This surge in footfall, combined with a significant rise in first-time bookers, shows the festival’s success in reaching new audiences and capitalising on its new location right at the heart of the Edinburgh Festivals footprint.
This was evident not least in the newly increased and re-targeted YA programme, which proved a resounding success, hitting its mark with readers 30 and under, solidifying the festival’s appeal to the next generation of literary enthusiasts.
Once again, The Front List strand of events, which increased from eleven to fifteen in 2025, were packed out with over 12,000 people turning up in person at McEwan Hall to hear from writers including literary titans Ian McEwan and Maggie O’Farrell, contemporary phenomena Asuko Yuzuki and R F Kuang, political heavyweights Yulia Navalnaya and Nicola Sturgeon, and even the celebrity co-creator of beloved sitcom Gavin and Stacey, Ruth Jones.
This year also marked a cornerstone moment for Scottish independent publishers and female writers. The bestseller list was topped by standout titles from Scottish women including Mairi Kidd’sThe Specimens, and event led titles including Katabasis by R. F. Kuang and Nicola Sturgeon’s Frankly.
Beyond the physical site, the festival’s digital reach expanded dramatically, connecting communities across 12 local authority areas by streaming events, free of charge, into over 40 libraries, which in turn hosted over 90 ‘watch parties’, as part of the newly launched Paper Trails initiative.
In addition, a global audience of almost 19,000 from 63 countries across five continents tuned in for streamed events, proving the festival’s ability to foster conversations that transcend geographical boundaries. And with events available for the rest of the year, and more to be added on an on-demand basis in Autumn, global audiences have lots more coming to enjoy.
This year’s program was defined by timely and important discussions that reflected a public hunger for considered, informed conversations on global issues. Sold-out events like the discussion with prominent Israeli historians Ilan Pappé and Avi Shlaim on the history of Israel and Palestine, a conversation between renowned journalists Lindsey Hilsum and Edward Wong, and several events looking at the impact of AI on literature and the arts more widely, exemplified this trend.
These events drew large audiences and sparked meaningful dialogue on topics of international significance, underlining the festival’s role in generating constructive in person conversations.
The brand new, dedicated Kids’ Zone was also a resounding success, providing a comfortable environment for families to relax and have fun for free, and complementing the children’s programme with unmissable opportunities to meet the Gruffalo, Pikachu and Supertato – and also, for the first time in book festival history, the real-life Princess the Unicorn.
Hosting just some of the sold-out events in the Children and Families programme were Julia Donaldson, who attended with her world premiere of Paper Chase, Cressida Cowellwho hosted a record-breaking back-to-back signing, ensuring hundreds of young people left with a memory that will last a lifetime, and the iconic Michael Rosen.
The festival’s continued growth in both physical attendance and online engagement demonstrates its enduring relevance, and by providing a space for a diverse range of voices and fostering conversations that matter, it continues to thrive and align with its audiences in both its fun-filled programming and its considered approach to conversations of global significance.
Health Secretary Neil Gray has welcomed an increase in the number of newly qualified paramedics joining the Scottish Ambulance Service, with 360 new recruits joining the service since 2023.
New figures show a steep increase in recruitment between 2022-23 and 2023-24, and a total recruitment of 489 since 2020.
The investment in newly qualified paramedics is designed to give the service more resilience, improve capacity and increase the number of patients treated in the community.
A three-year paramedic undergraduate degree programme was launched at Glasgow Caledonian University in 2017 and is now available at five universities across Scotland.
Figures for the last five years, which include graduates from outside Scotland, are:
2020-21 = 24
2021-22 = 58
2022-23 = 47
2023-24 = 179
2024-25 = 181
The number of paramedics currently working in Scotland is 2,156.6 whole time equivalent posts.
Health Secretary Neil Gray said: “The Scottish Ambulance Service is an absolutely vital part of the health service, so the Scottish Government is working hard to provide it with the staff and resources it needs to continue delivering a high-quality emergency service to people across Scotland.
“Since 2020, we have supported the recruitment of additional staff, with further recruitment already underway this year—bringing workforce levels to a record high.
“Ambulance staff have shown outstanding resilience in the face of sustained pressure, and I want to thank them for their continued dedication and hard work.”
Michael Dickson OBE Chief Executive of the Scottish Ambulance Service said: “We are delighted to welcome this number of newly qualified paramedics to SAS. This reflects their experience to date, and it also reinforces the important role paramedics can play in the future of NHS Scotland.
“Our continued ambition, supported by Scottish Government, is to grow and develop the SAS workforce, ensuring we continue to deliver the very best patient care by boosting capacity and increasing our resilience in communities across Scotland.”
‘SUCCESS REAFFIRMS EDINBURGH’S PLACE AS THE WORLD’S LEADING FESTIVAL CITY’
The 2025 Edinburgh International Festival programme was received with record enthusiasm this year, as 88% of all the tickets were sold, filling theatres and concert halls to the highest percentage in over a decade. More than half the performances across the programme sold out and the programme received critical acclaim with 81% 4* and 5* reviews.
The most international audience in recent years – from 91 countries – flocked to the International Festival this summer. Drawn by more than 2,000 artists and participants from across 41 countries, audiences experienced the world’s greatest theatre, dance, music and opera, often in unconventional settings.
The Festival was more inclusive and affordable than ever, with its sold-out first-ever dementia-friendly concert, the highest number of discount tickets issued to D/deaf, disabled and neurodivergent audience members and record subscriptions to the Festival’s free ‘Access Pass’, and half of all tickets priced at £30 or less.
The 2025 Edinburgh International Festival concluded yesterday after an extraordinary three-week celebration of opera, dance, music and theatre in Scotland’s capital.
The third under the leadership of Festival Director and Scottish violinist Nicola Benedetti, this year’s Festival was distinguished by a bold programme that both challenged and rewarded audiences. Over 2,000 artists from across 41 nations shared a range of perspectives, taking to stages in unconventional formats and settings across the city.
Over 111,000 audience members attended from 91 countries to enjoy the finest and most exciting performers from across the globe, including 7 world premieres, 8 UK and Scottish premieres, and 2 European premieres.
Kicking off with the world premiere of blockbuster play Make It Happen, which alone was attended by over 22,000 people, other highlights included the eight-hour choral epic The Veil of The Temple; an Australian circus reimagining of opera Orpheus and Eurydice; and Nederlands Dans Theater’s extraordinary Figures in Extinction.
The overall quality of the programme was recognised by audiences and critics alike, with 81% of starred reviews receiving 4 or 5 star ratings from critics and exceptional sales across the programme, with 66 sell out performances, and 88% of the total tickets available were issued.
Maintaining its industry-leading concessions, the International Festival prioritised affordability, with targeted pricing initiatives for those who need it most. Half of all tickets were priced £30 or under, including over 5,000 £10 tickets which were offered across every performance in the programme. In partnership with Tickets for Good, over 1,000 tickets were also donated to NHS staff, charity workers and low-income benefit recipients.
Expanding the Festival’s offering to the broadest possible audience, this year saw the first-ever dementia-friendly concert sell out as well as 18 performances and workshops in healthcare and community settings across the city.
Exceeding 2024 totals, 7,271 free and heavily discounted tickets were issued to D/deaf, disabled and neurodivergent people and 763 new audience members signed up for the free Access Pass, bringing total membership to a new high of over 2,000.
This year the International Festival also championed youth and emerging talent, creating pathways into transformative cultural experiences. A record-breaking 2,695 tickets were issued to young people from across Scotland to attend performances for free through the Young Musician’s Pass, as well as hundreds of Edinburgh’s secondary school pupils who deepened their engagement with the arts through performances and workshops.
24 Rising Star artists collaborated with International Festival mentors and performers on stage this year, contributing to a cohort of 45 early career classical musicians who have been supported with professional development opportunities since 2023.
In 2025, the Edinburgh Festival Chorus celebrated 60 years as the beating heart of the International Festival. Each year, non-professional singers from across Scotland come together to perform cornerstone works with some of the world’s greatest soloists, conductors and orchestras.
This year, the 160 volunteer chorus members performed for 10,000 attendees in a range of events including the monumental Opening Concert The Veil of the Temple, two performances as part of the London Symphony Orchestra residency, and the Closing Concert, Mendelssohn’s Elijah.
Inspired by their dedication, the 2025 programme offered an open invitation for people from all walks of life to come and sing: The Big Singalong in Princes St Gardens welcomed thousands to join Scottish legend Dougie MacLean in a rousing rendition of Caledonia, and 750 amateur singers enjoyed a full-day workshop taking on highlights from Mendelssohn’s epic Elijah.
Festival Director, Nicola Benedetti said: “This year’s International Festival has been one of extraordinary contrasts, from grandeur and scale to intimacy and informality. Through the theme The Truth We Seek, we were determined to challenge as well as entertain.
“In presenting innovative and risk-taking work we were able to spark debate, dialogue, and a healthy friction that audiences responded to in unprecedented numbers. I’ve seen this year how art can build bridges, change minds and find connection in a world that so desperately needs it.
“This Festival reminded us why we gather, why we create, and why we believe.”
Chief Executive, Francesca Hegyi said: “This year’s International Festival has been a remarkable celebration of ideas, welcoming audiences from across Scotland and 91 other countries.
“Its success reaffirms Edinburgh’s place as the world’s leading Festival City, and the International Festival itself as a global cultural beacon each August.
“Our commitment to accessibility, youth engagement and artistic excellence has never been stronger, from our sell-out first-ever dementia-friendly concert to record-breaking take-up of the Young Musician’s Pass.
“The International Festival is not only a showcase of world-class performance, but also a vital meeting place for cultures, ideas and audiences worldwide. It’s this collection of talent and annual exchange of ideas that sets it apart on the global stage.”
Foysol Choudhury MSP has called on the Edinburgh Integration Joint Board (EIJB) to pause £29 million of proposed cuts to health and social care, warning that the measures would have devastating consequences for vulnerable people across the city.
The EIJB is set to decide on the cuts today. If approved, they could result in:
More than 4,000 people losing community mental health support
£2.2 million of Thrive Edinburgh contracts cancelled
82% of Collective Advocacy at CAPS disappearing by November
Closure of services such as Pilton Community Health Project and Bipolar Edinburgh
Mr Choudhury said: “I recognise that the Board faces huge financial pressures. These are difficult decisions that no one wishes to make. However, the reality is that the EIJB has been forced into this impossible position because of chronic underfunding from the SNP Government.
“These cuts are not just about numbers on a balance sheet. They represent real people losing vital support, families, communities, and some of Edinburgh’s most vulnerable being left without the services they rely upon.
“I urge the Board to carefully consider the human impact, not just the balance sheet; and to pause these cuts. Edinburgh deserves sustainable funding, not short-term measures that will cause long-term harm. Services must remain available to users while new approaches are explored.”
A ‘major public consultation’ on the future development of Edinburgh’s tram network opened yesterday (25 August) and will run for 12 weeks.
The Council are seeking the public’s views on the proposed new tram routes from Granton in the north of the city to the Edinburgh BioQuarter and Royal Infirmary of Edinburgh in the south.
A detailed business case was developed to extend the existing route from Edinburgh Airport to Newhaven, which was successfully completed in 2023 and now carries over a million passengers a month.
This consultation will inform the development of a Strategic Business Case (SBC) for the expansion, which will then be presented to the Transport and Environment Committee in 2026.
The proposed new route can be broken down into three main sections:
GRANTON TO THE CITY CENTRE:
From Granton to Ferry Road / Crewe Toll there is a single route. From Ferry Road / Crewe Toll to the following section, two alternative route options are being considered: the Orchard Brae corridor or the Roseburn Path.
For Orchard Brae, the route would head to the west end of Princes Street along Orchard Brae, Queensferry Road (via the Dean Bridge) and Queensferry Street.
It is estimated that this option would cost between £650m – £850m and is forecast to carry around 3.75m passengers per annum by 2042.
For Roseburn Path, the route connects to the existing line west of Haymarket via an old railway line which winds from Ferry Road/Crewe Toll before reaching Craigleith and heading towards the west end and city centre.
This option is estimated to cost between £350m-£480m and is forecast to carry around 4.25m passengers per annum by 2042.
It also examines the potential to install high quality walking, wheeling and cycling alongside the tramline on the Roseburn Path, and look at the potential to protect and enhance the local ecological network.
The entire route is forecast to cost between £2bn-2.9bn, depending on the final options selected, and carry around 38m passengers by 2042.
CITY CENTRE TO BIOQUARTER & ROYAL INFIRMARY
The proposed route would begin at Princes Street on the existing tram infrastructure, allowing bus and rail interchange in the heart of the city centre.
The route would then cross the North Bridge, and run through Nicolson Street, Newington and on to Cameron Toll, then west towards the BioQuarter and Royal Infirmary of Edinburgh.
POTENTIAL EXTENSIONS TO MIDLOTHIAN and EAST LOTHIAN
The city council is working closely with Midlothian and East Lothian Councils and SEStran, the regional transport partnership, regarding potential future mass transit connections beyond the BioQuarter and Royal Infirmary.
This includes exploring a ‘tram-train’ (a light rail vehicle than can operate on tram and rail tracks) concept with Network Rail on the old Edinburgh South Suburban Railway (ESSR).
Other potential options include connections with Musselburgh Railway station and Queen Margaret University (QMU) in East Lothian and to Shawfair with interchange opportunities into Midlothian and the Scottish Borders.
Transport and Environment Convener, Councillor Stephen Jenkinson said: “I’m pleased that we’ve reached this key stage for extending our multi award-winning tram service.
“We need to prepare for the future. Edinburgh is the fastest growing city in Scotland, with more than 60,000 new residents expected over the next 20 years. Whilst this shift is a true sign of our success, it brings real pressure on our communities, and crucially on the city’s transport infrastructure on which we all rely.
“Managing this growth also means tackling the climate, nature and housing emergencies. To meet these significant challenges, we need to look for bold and ambitious solutions and the tram extension is central to this.
“Edinburgh Trams already offers a reliable and fast service, allowing residents and visitors to move around sustainably and efficiently, and with some of the cheapest fares in the country. The broader benefits of cleaner air and emphasis on active travel surrounding the network are equally as important.
“Our overarching vision is to truly link our city for the benefit of all. From our flagship £1.3bn development at Granton Waterfront through to the city centre, our world-famous universities, cultural hubs, brilliant local businesses, new housing developments, hospitals and beyond; our transport network must move with the times.
“The new developments we will see along the tram route will be key to Edinburgh’s prosperity for generations to come.
“I’d encourage everyone to engage with this consultation and help to shape the next chapter in the history of Edinburgh’s transport.”
The full details of all the sections mentioned above can be found in the consultation papers.
Residents can give their views until 17 November online on the Consultation Hub or at in person drop-in sessions. Details of these sessions are also on our Consultation Hub.
The next step, should members agree on the SBC, would be to move to the next stage of development, as set out by Transport Scotland, which is the OBC.
DROP-IN SESSIONS
Drop-in at Blackhall Primary SchoolFrom 2 Sep 2025 at 16:00 to 2 Sep 2025 at 19:00More informationBlackhall Primary School, 83 Craigcrook Road, EH4 3PH Add to my Calendar (.ics)
The second annual Printmakers of Scotland (PoS) Festival, held recently at Stirling University, proved to be a great success with over 1400 visitors attending the two day event.
The festival, organised by the PoS artists’ collective, resulted in the sale of about £50,000 worth of prints and saw 28 prizes and certificates being awarded to many of the 45 participating printmakers.
The event also featured ten different demonstrations of printmaking that offered festival visitors the chance to participate.
Organiser Deb Wing commented: “Our second festival has gone very well with an increase in visitors on last year and outstanding feedback from both visitors and all of the 45 artists who were on show.
“Positive comments from visitors included ‘The range of printmaking styles and techniques is amazing,’ to ‘A beautiful selection of different print styles. It was lovely to meet the artists.’
“Some members of the public benefitted for our Quiet Hour first thing in the morning when there was restricted access for us to welcome visitors who face particular challenges in a crowded event. This reflects Printmakers of Scotland’s ongoing commitment to inclusion in our events.
“We will soon begin the process of planning our third festival in 2026 and can only see the event going from strength to strength.”