The Royal Osteoporosis Society calls for improved fracture prevention services in Scotland after report shows the shocking scale of under-diagnosis and under-treatment
This month, the Scottish Government National Audit Programme Board has agreed to introduce a national audit for Fracture Liaison Services (FLS), following an inquiry which showed the increasing scale of under-diagnosis and under-treatment in the NHS.
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. The condition affects around 300,000 people in Scotland and it’s estimated that 44,000 ‘fragility’ fractures occur here every year.3
Pioneered in Scotland and copied across the world, FLS are the tried and tested model for systematically identifying people aged 50 and older who have had a fracture (broken bone) and moving them onto a treatment plan.
People who have already fractured a bone are at a heightened risk of further fractures unless they’re identified and have access to appropriate medication to strengthen their bones. In women aged 50 and over, 23% of second fractures happen within a year of the first fracture but osteoporosis drug treatments reduce the risk of further fractures.
Last year an inquiry led by the Royal Osteoporosis Society (ROS), highlighted inequalities in access to FLS. Scotland currently has a notional figure of 100% population coverage of FLS, whereas in England and Wales the proportion drops to 51%.
Yet, unlike the rest of the UK, the lack of a central Scottish database means there is no measure of how those services are performing, creating stubborn health inequalities across different areas.
Clinicians in England, Wales and Northern Ireland already share data through a central Fracture Liaison Service Database, which makes public important data about the quality of services, and helps drive learning and improvement for people living with osteoporosis. A new Scottish Audit of Fracture Liaison Services will reach an estimated 40,000 patients per year.
Pam Duncan-Glancy MSP, Convener of the Arthritis and MSK Conditions CPG, said: “We know there’s work to do to make sure everyone has the best chance of living in good health, with a good quality of life, for as long as possible. This includes ensuring the best possible care, delivered when we need it, as effectively and efficiently as possible.
“We know that when it comes to fracture care, there is still work to be done. This audit will help identify what needs to be done, when and where, so that we can all work together to improve the quality of life of everyone in Scotland.”
The ROS is the UK’s only national charity dedicated to bone health and osteoporosis.
Craig Jones, CEO of the Royal Osteoporosis Society said: “We know that people who have suffered their first fracture are at a high risk of further fractures, which is why early diagnosis and access to the right treatment options are so crucial.
“We’re pleased the Scottish Government has made the first step towards setting up a national audit and we welcome their decision to share data with the rest of the UK.”
Although the decision to set up a new national audit has been approved by the Scottish Government National Audit Programme Board, funding will still need to be found to set up the audit.
Craig Jones continues: “The new national audit will provide a benchmark for the standard of Fracture Liaison Services, helping healthcare teams learn from their own performance and the work of other teams across Scotland.
“Now we have agreement that an audit is needed, we must work together to secure funding so we can make it happen.
“If we create this audit, we can raise the standard of osteoporosis services across Scotland and end the postcode lottery that is putting thousands of people at risk of preventable broken bones.”
You can find out more information about Fracture Liaison Services at: https://theros.org.uk/blog/what-is-a-fracture-liaison-service/