Fracture Liaison Services

Baroness Donaghy Excerpts

Wednesday 4th December 2024 Lords Chamber

[Baroness Donaghy (Lab)]

I am grateful to the noble Lord, Lord Black of Brentwood, for moving this debate so clearly and comprehensively. I hope that this is not an example of winning the argument, winning the campaign and then losing the starting gun. We need three things to happen immediately. We need that transformation fund to pump-prime fracture liaison services for the first 18 to 24 months when, as the noble Lord, Lord Black, has said, it is estimated that they will start paying for themselves. We need to allow the six integrated care boards that are ready now to begin commissioning services to go ahead, if necessary with some of that transformation fund to support them and, if necessary, before the national rollout plan.

We need clear leadership from the Government and the NHS so that there is a deliverable timetable to ensure that the half of the population not covered by fracture liaison services will be covered by 2030. Just one year’s delay will halve the total hospital bed days saved by 2029, compounding the burden on the NHS. Leadership is vital, because patients find it challenging to keep taking common osteoporosis medications, because they must be taken in a particular way and can cause side-effects. Patients do not feel better from taking them; they reduce long-term fracture risk rather than addressing any current symptoms. One GP who is extremely knowledgeable and committed in this area described how difficult it was to keep patients motivated to take their medication because of ignorance of the subject, no visible changes and the pressures in the system which mean failures to follow up. In England, only 36% of potential patients are reached.

Also, access to diagnostic services varies by region. There is a shortage of DEXA bone density scans and a shortage of radiographers. NHS England indicated that, in September 2024, 56,366 patients were waiting for a DEXA scan and 18.5% had been waiting for more than the target of six weeks. Believe it or not, that is an improvement on the 33.6% waiting more than six weeks in September last year.

I am a member of the Royal Osteoporosis Society and I believed, when I joined it 12 years ago, that we had no osteoporosis in our family. I then discovered, 18 months ago, that my only brother had been diagnosed with it. This can hit in the most unexpected circumstances. I therefore urge the Government to give some indication of when the rollout may happen and when that transformation fund might become available.