Tag: osteoporosis

Poor quality bone services in Scotland have led to a devastating rise in broken hips, putting older people’s lives at peril

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.

Just 30% were admitted to a ward within the four-hour target in 2024, which compares with 37% in 2023. Scottish hip fracture audit – reporting on 2024 – Scottish Hip Fracture Audit – Publications – Public Health Scotland    

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.

University develops care home workers as osteoporosis champions

WORLD OSTEOPOROSIS DAY – 20 OCTOBER

A university project, which is raising awareness of the shocking rise of osteoporosis in adults across the UK, is to provide specialist education for care home workers and community champions.

On World Osteoporosis Day (20th October ‘24) Queen Margaret University (QMU), Edinburgh announced that it is expanding its vital work to ensure osteoporosis is viewed as a public health priority.

The University team will be encouraging staff from care homes, and people living with the condition, to become better educated about the common bone disease which affects over 3 million people in the UK.

Osteoporosis is a common bone disease that weakens bones, making them fragile and more likely to break. Developing slowly over several years, it’s often only diagnosed when a fall or sudden impact causes a bone to fracture.

Affecting over 250,000 in Scotland and accounting for around 527,000 fractures per year in the UK, QMU’s Lydia Osteoporosis Project is passionate about raising awareness to help halt the rising numbers of people affected by the condition.

Although it is frequently perceived as a condition primarily affecting postmenopausal women (affecting 1 in 2 women over 50), evidence indicates that osteoporosis affects approximately 1 in 5 men over the age of 50.

Given its often ‘silent’ progression until fractures occur, it frequently evades diagnosis until it reaches an advanced stage.

Dr Karen Matthews, who leads the Lydia Osteoporosis Project at QMU, explained: “Osteoporosis silently undermines bone strength over time. Often, it remains undetected until a simple fall or sudden impact results in a debilitating fracture.

“Typically, individuals with osteoporosis experience fractures in their wrists, hips, or spinal bones. It can even lead to a broken rib or partial spinal bone collapse triggered by a mere cough or sneeze.

“Older people can develop the characteristic stooped posture as their spinal bones weaken and are unable to bear their body weight.”

Due to our increasing aging population, osteoporosis is now increasingly prevalent, with a high incidence of people with the condition living in a care home setting, as well as in the community.

Dr Matthews explained: “It is not always obvious that someone has osteoporosis, as it can essentially be a hidden disease. But it is critical that staff in care homes and health care settings develop a better understanding of the condition so they can prevent any unnecessary bone fractures when moving or handling patients.

“Care homes workers who may be moving people in and out of beds, chairs, wheelchairs etc., or even helping them wash or change, need to be aware of the condition, to avoid handling which may cause people’s weakened bones to fracture accidentally.

“Staff in care homes, healthcare professions and the public can all benefit from improved knowledge about preventing osteoporosis through lifestyle choices, physical activity, and a balanced, bone-healthy diet, as well as how to prevent unnecessary fractures.”

Dr Matthews emphasised: “We cannot underestimate the importance of care home staff when it comes to the care and welfare of our elderly population. We must invest in their education and professional development so they are equipped with the skills and knowledge to give the best care to their residents. 

“That’s why Queen Margaret University will be offering a number of free modules as scholarships to individuals working in the care home sector. We want to develop a community of Lydia Osteoporosis Champions who can help to raise awareness of this important condition within the sector.”

The QMU team is also keen to develop champions in the community who can work to reduce the incidence of osteoporosis within the population by promoting good bone health and preventative behaviours such as weight bearing exercise and healthy eating.

Dr Matthews concluded: “Osteoporosis is now such a significant health problem in today’s society that it needs to be viewed and addressed as a public health priority.

“Education and research are key to raising awareness. That’s why we are ensuring it’s taught as part of our undergraduate and postgraduate healthcare professional courses at QMU, and in our PgDip Advancing Care Home Practice (Person-Centred Practice).

“But we also need to reach people who are already in healthcare roles to spread awareness of knowledge across healthcare settings. Partnerships with staff in care homes and other healthcare settings are going to be crucial to our development of Lydia Osteoporosis Champions. 

“Ultimately this will improve person-centred care of people living with osteoporosis across our care home sector, and reduce the prevalence of this worrying condition in Scotland and the UK.”

Scots are not looking after their bones, charity research reveals

TV’s Trisha Goddard takes up new role to raise awareness of healthy bones in response to new research

Presenter and Journalist Trisha Goddard is sharing her experience with breast cancer to raise awareness of the life-changing importance of strong bones, as new research reveals a worrying lack of action among the public. 

Osteoporosis will affect half of women and 1 in 5 men over 50, but despite this, new research by You Gov and commissioned by the Royal Osteoporosis Society (ROS) shows that only 40% of Scots under 55 actively try to prevent it.  

The condition weakens bones, making them more likely to break and affects 3.5 million people in the UK.

In 2008, Trisha was warned that her bones would lose strength as a result of her breast cancer treatment – unless she took decisive action.

Today, Trisha is sharing the lessons from one of the toughest periods of her life as a message of hope for people of all ages: that by taking action to strengthen your bones, we can all live better in older age and avoid the pain and disability of osteoporosis.

Trisha said: “I never really gave osteoporosis or my bone density a thought until it came to my breast cancer treatment. My surgeon explained that the medication I would be on for the next ten years would affect my bones.

“While I was ill, the hospital tested my bone density and I was pleasantly surprised to find out that at the age of 50, it was still really good. All the weight training and powerwalking I had done for half my life had paid off. There was no need for me to be prescribed any additional medication to help preserve my bones through the cancer treatment.

“After five years of being on breast cancer medication, my surgeon checked my bone density again. Great news! I’d barely lost any of my bone density. My surgeon happily explained that this was a direct result of me continuing to weight train, power walk and stay active.

“All that time, my aim had been to stay physically and mentally strong. Without even realising it, not only had I maintained my muscle strength, I had also maintained my bone strength.

“I’m not going to pretend it was easy – far from it – but a little bit of exercise most days was what got me through cancer. I’ll always have worries about my health, but it gives me peace of mind knowing that I’m in control of my bone health.”

Despite the huge impact for individuals and society, the research shows that 54% of people living in Scotland have never even had a conversation about bone health. In comparison, 69% actively try to maintain a healthy weight. 

Trisha continued: “The whole experience made me realise how important it is, not just for cancer patients, but for everyone to look after their bones.

“Bone health is so overlooked when it comes to wellbeing. It absolutely brought home to me that prevention is better than cure. That’s why I’m joining forces with the Royal Osteoporosis Society to raise awareness of the importance of bone health.”

The ROS has announced that Trisha is to become an Ambassador for the charity as part of its mission to bust myths and improve the bone health of the nation.

More people die of fracture-related causes than deaths caused by lung cancer and diabetes.

The disease costs the NHS £4.5bn per year, a figure set to rise as the population ages. The ROS has warned this may climb even higher following the effects of lockdown, as the research shows that worryingly over a third of people in Scotland (37%) have exercised less during the pandemic.

Craig Jones, Chief Executive of the Royal Osteoporosis Society said: “Trisha is living proof that the fatalism about osteoporosis and broken bones being just part of getting older is plain wrong. 

“There are many things that can increase your risk of osteoporosis, and sadly some cancer treatments are one of them. Many people will need to take a drug treatment for their bones to counteract the effects of their cancer treatment which will reduce their risk of bones becoming fragile.  

“Thankfully, taking weight-bearing exercise, getting enough vitamin D and eating the right foods can also make a big difference, not just for cancer patients but for everyone who wants to proactively manage their bone health.

“It’s typical of Trisha’s openness and can-do attitude that she’s sharing this inspiring message about how to age better and stop osteoporosis in its tracks.”

The popular presenter launched her 30-year career in television in Australia, before becoming a household name in the UK, where she fronted her celebrated BAFTA-winning talk show, which ran for 12 years.

Trisha is a life-long advocate for mental health services, and her time in the public eye has been characterised by her willingness to share candidly her own experiences to support people who are battling adversity.

Trisha is poised to return to our screens this summer as host of a new, more holistic version of Channel 5’s show, You Are What You Eat. Trisha will also be part of campaigning efforts by the ROS to raise awareness of bone health and work towards its goal of a future without osteoporosis.

Find out more about bone health at https://theros.org.uk/.