Tag: Royal Osteoporosis Society

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.

40,000 patients in Scotland to benefit a year from new audit

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/

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/.