Fracture Liaison Services

Baroness Bull Excerpts

Wednesday 4th December 2024 Lords Chamber

[Baroness Bull (CB)]

My Lords, I thank the noble Lord, Lord Black of Brentwood, for securing this debate and for his tireless work in championing fracture prevention. I also ask the House to note that I am an ambassador for the Royal Osteoporosis Society.

Over the past 30 years, osteoporosis and bone health have been a blind spot in the women’s health policies of successive Governments. Some 50% of women over 50 will suffer fractures due to the condition, and the vast majority of the 90,000 people missing out on anti-osteoporosis medication are women. For this reason, the Fawcett Society, the British Menopause Society, Mumsnet and Gransnet are among the many charities and organisations supporting the Better Bones campaign.

The noble Lord, Lord Black, raised the idea of pump-priming new fracture liaison services with a time-limited transformation fund. I want to highlight the compelling example of exactly this approach in Wales, where the noble Baroness, Lady Morgan of Ely, has shown courageous leadership on the issue. In February 2023, as the then Welsh Health Secretary, the noble Baroness, Lady Morgan, made a bold commitment to mandating fracture liaison services in all health boards within 18 months. By September 2024, that target had been met, with every acute health board in Wales now providing fracture liaison services—an extraordinary achievement, but it did not happen by mandate alone.

As we heard, fracture liaison services quickly prove their value, breaking even within just 18 to 24 months. Beyond this point, they become cost-saving, preventing fractures and reducing hospital admissions to more than cover their ongoing costs. This is why pump-prime funding is so crucial, as it bridges that short window before the benefits become fully realised. The noble Baroness, Lady Morgan, recognised this when she pump-primed new fracture liaison services. As a result, Wales achieved universal coverage in under two years, showing what can be accomplished when ambition is backed with resource.

During the last QSD on this matter, the noble Lord, Lord Evans of Rainow, responded for the Government and warmly endorsed the idea of what he called a “fracture tsar” within NHS England. Unfortunately, the previous Government did not follow through to establish such a role. The APPG on osteoporosis also noted the need for strong, visible leadership across local systems to get these services up and running. Osteoporosis falls between the cracks of clinical specialties, which is one reason it has been neglected historically. The APPG’s 2022 report recommended the appointment of a “national specialty adviser”—a tsar by another name—to address the lack of ownership and cut across historic boundaries between medical specialisms. I hope that this Government might take action on this where the previous one did not.

The Welsh example shows that a universal fracture liaison service is achievable, but it requires strong leadership and pump-priming to succeed. The Minister has been a steadfast advocate for universal fracture liaison services over many years. I hope that, in responding, she will confirm that the Government are willing to put both leadership and funding in place, so that the ambition for universal coverage is no longer just a commitment but becomes a reality.