House of Lords
Introduction: Lord Leunig
Introduction: Baroness Ussher
Fracture Liaison Services
(1 day, 18 hours ago)
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Lord Black of Brentwood
To ask His Majesty’s Government what is the net number of new Fracture Liaison Services that have opened in England since July 2024.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, the latest analysis of 2025 data from the fracture liaison service database shows that the number of fracture liaison services in England has increased from 73 to 78 since 2024. The database does not provide monthly data on the number of fracture liaison services, so we are unable to provide information on how many new services have opened since July 2024.
Lord Black of Brentwood (Con)
My Lords, at the general election, 73 fracture liaison services covered half the country. The incoming Government pledged to deliver national rollout to every part of England by 2030—in other words, doubling that number to more than 130— and we all cheered. But today, nearly midway through the Parliament, that figure, as the noble Baroness said, stands at just 78: a woeful increase of just five. Given the anaemic rate of progress, can the noble Baroness tell us in very simple terms what concrete action the Government will take to deliver the remaining 50-plus new FLS by 2030, how that will be funded, and when we will get the implementation plan we have been promised?
Baroness Merron (Lab)
The commitment remains the same, as the noble Lord will have seen most recently outlined in the women’s health strategy. We are taking a whole-pathway approach of fracture prevention, improving access to diagnosis, adopting effective treatments and encouraging local systems to develop services to identify those at the highest rate of fracture. The noble Lord knows that I cannot offer an implementation plan exactly as he would like—I thank him for his strength of feeling on this—but I hope this shows the progress we will continue to make.
Baroness Pidgeon (LD)
My Lords, if fracture liaison services can prevent further fractures and help people remain independent, what assessment have the Government made of whether rollout could be accelerated, and what would need to happen to achieve full coverage before 2030?
Baroness Merron (Lab)
The 10-year health plan also highlights community-based models of fracture prevention services, which will be very much at the core of neighbourhood health services; that is one of the key changes we are making. It is important to emphasise, as I have done before at this Dispatch Box, that decisions are rightly made at a local level, that that is how local populations are best served and that that will continue.
Baroness Hayter of Kentish Town (Lab)
My noble friend knows that leaving it to local services is simply not providing—
Captain of the Honourable Corps of Gentlemen-at-Arms and Chief Whip (Lord Kennedy of Southwark) (Lab Co-op)
It is the turn of the Cross Benches. We will then hear from the Labour Benches.
Baroness Murphy (CB)
My Lords, fractures of the hip are killers for people in old age. Up to 25,000 older people die every year after a hip fracture, usually several years before their allotted time. Does it not seem to the Minister that we should give more energy to getting these fracture liaison services, which are incredibly cheap, up and running in every district? Scotland has done it. Northern Ireland has done it. I do not understand why England and Wales cannot do it, too.
Baroness Merron (Lab)
We are extending services. The noble Baroness’s observation on the implication of not dealing with this issue is quite right, which is why I talked about the whole pathway of fracture prevention. For example, on prevention, we have invested £2.6 million in 20 new, state-of-the-art DEXA scanners across the country. That builds on the first wave of investment, with £1.9 million invested in 13 of them last year, which massively increases capacity. I share noble Lords’ wish to see us do as much as we can, which is why we are taking a whole approach to this matter in terms of prevention, diagnosis and treatment.
Baroness Hayter of Kentish Town (Lab)
My Lords, my noble friend the Minister knows that we simply will not reach the target without a push from government: leaving it to local services simply will not do it. When my noble friend has finished with Second Reading of the Health Bill today, I will table an amendment to make sure that there is a plan to reach the implementation day. I hope she will then engage with us, at the point of the amendment, so that we really can make progress on this issue.
Baroness Merron (Lab)
I am grateful to my noble friend for allowing me to complete Second Reading today—I look forward to doing so—but I do not share her feeling that we will not be providing services. As I have said, the commitment is there. I should say that the department is working with NHS England to ensure that secondary fracture prevention remains a priority. We are doing this in several ways, including by ensuring that guidance is regularly reviewed and that we can improve data. I will be very pleased to share further details in due course.
Baroness Verma (Con)
My Lords, on prevention, as women get to the perimenopausal stage in life, our bones become a lot thinner. Would it not be helpful and useful, while the Government are rolling out other things, to do some public awareness on where women can get support and help in the meantime. That would of course be national and would not have to be rolled out.
Baroness Merron (Lab)
The noble Baroness makes a good point, and we are now including menopause in the NHS health check for those over 40. That will be a very good place to do that, because it will identify where women should speak up. One in three women are likely to have osteoporosis, compared with one in five men.
Baroness Altmann (Non-Afl)
My Lords, fractures caused by osteoporosis cost businesses about £160 million a year, yet progress on fracture prevention services has stalled, with patients, NHS and employers losing out through this delay. Can the Minister, who I know cares deeply about this issue, give the House a date for the rollout plan to reassure everyone that the Government intend to get delivery back on track for the 2030 universal coverage deadline?
Baroness Merron (Lab)
I do not accept the analysis on rolling back—we are going forward compared with where we started. I understand the frustration, which we all share; however, my officials are progressing policy options, including the upcoming frailty and dementia modern service framework, through which we can set local targets for ICBs, for example. We will be led by evidence on that, because we want to improve health and care for what is, as the noble Baroness says, a very important cohort.
Baroness Nargund (Lab)
My Lords, I thank my noble friend the Minister for including support for women with osteoporosis in the Renewed Women’s Health Strategy for England. What plans are in place to ensure that the ICBs will give women equal access to fracture liaison services, so that we can prevent further fractures?
Baroness Merron (Lab)
While many areas have made good progress, there is still variation in service provision and issues with patient access. That is why we are improving identification, assessment and treatment of people at risk of fragility fractures. On the point about women, in the last four years two new drugs have been recommended by NICE for the treatment of osteoporosis; they will help to strengthen the bones and prevent bone loss. This, NICE publishing, updated guidance and the other measures we are taking will improve fracture liaison services, including prevention.
Lord Kamall (Con)
My Lords, I thank my noble friend Lord Black and the noble Baroness, Lady Hayter, for their persistence on this issue. It is welcome that the Government have made a commitment to roll out universal fracture liaison services by 2030, but who will be responsible for setting implementation milestones, interim target dates and reporting on the 2030 target?
Baroness Merron (Lab)
In line with all the other things we do, we have a range of measures. I have just spoken about the modern service framework, which is a new way of holding to account and it allows us to set targets for ICBs. It is important to say that NHS England and the department work to ensure that we make progress, but at the end of it all, in order to meet the needs of local communities, local services are best provided by those who are the local service providers. That does not change.
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