Musculoskeletal Health

Baroness Donaghy Excerpts

Thursday 30th January 2025 Lords Chamber

[Baroness Merron (Lab)]

I pay tribute to the noble Lord’s campaigning, which is impressive in maintaining focus on what I regard as a very important area. He may be aware, but I draw it to his and your Lordships’ House’s attention, that a Written Ministerial Statement about addressing urgent challenges was laid today. It outlines the fact that planning guidance is soon to be published—it was not published as I entered the Chamber—and will reflect patient priorities that are important to those who have to contend with osteoporosis. These include cutting waiting times, improving access to primary care—bearing in mind that 30% of GP appointments are related to MSK—and improving urgent and emergency care. On the point the noble Lord asks about, as I have said before, we are working closely to consider a whole range of options to provide better quality and access to important preventive services as part of ending the postcode lottery. I will be pleased to keep him informed.

[Baroness Donaghy (Lab)]

My Lords—

[Baroness Blackstone (Lab)]

My Lords—

[Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)]

We will hear from the noble Baroness, Lady Donaghy.

[Baroness Donaghy (Lab)]

I am a member of the APPG on osteoporosis, and we are very worried that fracture liaison services have been deprioritised in the recent NHS planning guidance. We know that the pump-priming transformation fund works because we have seen it working in Wales. It saves lives, as the noble Lord, Lord Black, said, releases people into the labour market, releases beds in hospitals and improves quality of life for thousands of people. Can the Minister give us an assurance? If this milestone has been missed in the planning guidance, we need urgent clarity on how the 2030 target will be reached.

[Baroness Merron (Lab)]

My noble friend raises a number of important points. In reference to the planning guidance, I hope she will understand that at this stage that is leaked information and I am therefore not in a position to comment. The Secretary of State has confirmed that planning guidance will be published in due course. I agree that patients around the country are waiting too long for care and treatment. I draw my noble friend’s attention to the plan for change, which will get the health service back on its feet. Part of the elective recovery plan, published just a few weeks ago, sets out funding to boost DEXA, which is bone density scanning capacity to support improvements in bone health and early diagnosis, including for osteoporosis. That will provide an estimated 29,000 extra scans per year, so I hope my noble friend will take heart from that node of direction.

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.