Health: Osteoporosis and Fractures

Baroness Chisholm of Owlpen Excerpts

Thursday 14th September 2023 Grand Committee

[Baroness Chisholm of Owlpen (Non-Afl)]

My Lords, I thank the noble Lord, Lord Black, for initiating this debate. I have long been involved with the Royal Osteoporosis Society and, in the short time available to me, I am going to have to gallop through what I want to say.

As has been part of the campaign in the Sunday Express, I am going to set out the reasons why a national leadership on osteoporosis and fracture prevention within the NHS is essential. Either a national clinical director or, at the very least, a national speciality adviser will enable us to have a strong, visible leadership. There is already a long list of 41 leadership roles within NHS England for virtually every condition—from long Covid to flu, from tobacco addition to eye care—and it seems to me the fact that fracture prevention is not mentioned on that list sends a clear message to local commissioners that it is not a priority.

Surely that is wrong. When you consider—as the noble Lords, Lord Black and Lord Alderdice, mentioned—that half of women over 50 will have a fracture due to osteoporosis and that these fractures are the fourth worst cause of disability and premature death in the UK today, it is a no-brainer that osteoporosis and fracture prevention should be represented with national leadership. I am aware that it is felt that the present NHS national director for musculoskeletal conditions includes osteoporosis in the portfolio, but the existing leadership bandwidth is extremely stretched, and osteoporosis is such a distinct specialism, so even if it continues in the MSK basket, in my book there is still a very strong case for a national speciality adviser.

From what I have learnt, good intentions at national level are failing to filter down across ICSs, leading to commissioners’ awareness being extremely low when it comes to the financial benefits brought by increasing FLSs. We need a specialistic leader in NHS England, properly resourced to get the job done. For over a year, the ROS has indicated that it will part fund such a role, surely an offer that NHS England should embrace. Rumours are that there is a freeze on recruitment, but that appears to have been lifted, as there is a recent advert for two new clinical director roles—so a place for us. On what possible NHS England criterion can a condition which affects so many people and costs so many years of healthy life and creates such a strain on public services possibly be allowed to continue?