Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many sick days a year are caused by osteoporotic fractures; whether they have conducted any studies into what impact investment to provide universal, high-quality Fracture Liaison Services across England would have on this figure; and if no such study has been made, whether they intend to commission one.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
23.4 million days were lost due to sickness absence in 2022 where the condition given was a musculoskeletal condition. This represented 12.6% of all days lost to sickness absence and was the third most common reason. Musculoskeletal conditions include back pain, neck and upper limb problems and other musculoskeletal conditions. This may include osteoporosis but sickness absence data for this specific condition is not held by the Department.
The International Osteoporosis Foundation’s report ‘BROKEN BONES, BROKEN LIVES: A roadmap to solve the fragility fracture crisis in Europe’ found that the total number of sick days taken after a fragility fracture in the United Kingdom in 2017 was over 2.5 million days. No studies have been carried out into what impact investment to provide universal, high-quality Fracture Liaison Services across England would have on sick days caused by osteoporotic fractures, and there are currently no plans to commission any.
In August 2023, we set out our initial plans for the Major Conditions Strategy within the Case for Change and our Strategic Framework. This initial report sets out what we have learned so far, and shares what we plan to focus on next to develop the final strategy. This included, together with NHS England, exploring further supporting the provision of Fracture Liaison Services.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have conducted any studies into the savings which would accrue to the NHS from investment to enable universal, high-quality Fracture Liaison Services across England; and if no such study has been made, whether they intend to commission one.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We continue to work closely with stakeholders, including the Royal Osteoporosis Society, to further understand the needs of people living with osteoporosis and consider how health and care services can better support them. Fracture Liaison Services are key to prompt diagnosis of osteoporosis and are acknowledged as the world standard for secondary fracture prevention. According to the Royal Osteoporosis Society, for every £1 spend on Fracture Liaison Services in the United Kingdom, £3.26 is saved by the National Health Service.
The National Institute for Health and Care Research welcomes funding applications for research into any aspect of human health, including Fracture Liaison Services.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have made any assessment of the impact of fragility fractures caused by undiagnosed osteoporosis on informal care-givers of working age; and what the impact of this is on the labour market.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Unpaid carers play a vital role in our communities, and we all owe them a debt of gratitude. We want unpaid carers to live healthy and fulfilling lives alongside their caring role.
No assessment, specifically on the impact of fragility fractures caused by undiagnosed osteoporosis on informal caregivers of working age; and what the impact of this is on the labour market, has been made. However, the Care Act (2014) requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for unpaid carers. Local authorities are required to undertake a Carer’s Assessment for any unpaid carer who appears to have a need for support and to meet their eligible needs on request from the carer.
In 2023/24, £327 million of funding from the Better Care Fund have been earmarked to provide short breaks and respite services for carers. This also funds additional advice and support to carers and a small number of additional local authority duties.
The enormous contribution made by unpaid carers is reflected throughout the social care reform white paper People at the Heart of Care, published in December 2021, and Next Steps to put People at the Heart of Care, published in April 2023.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to their commitment in the Major Conditions Strategy: case for change and our strategic framework, published on 14 August and updated on 21 August, to set up more fracture liaison services, whether the responsibility for that initiative lies with the Department of Health and Social Care or with NHS England.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
In August 2023, we set out our initial plans for the Major Conditions Strategy within the Case for change and our strategic framework. This initial report sets out what we have learned so far, and shares what we plan to focus on next to develop the final strategy. This includes, together with NHS England, exploring further support for the provision of Fracture Liaison Services. This could include identifying people at risk of further osteoporotic fragility fracture and implementing strategies to reduce the risk of future fracture (including falls) and mortality.
The final strategy will be published in early 2024.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of by the scientific accuracy of the Health and Safety Executive's guidance on blood borne virus transmission.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Health and Safety Executive (HSE) is Britain’s national regulator for workplace health and safety. It prevents work-related death, injury and ill health. No assessment has been made, however the HSE guidance on bloodborne virus transmission references current UK Health Security Agency (UKHSA) scientific evidence on risk of transmission of blood-borne viruses.
UKHSA provides advice on management of exposure to blood-borne viruses in occupational settings through its local, regional and national health protection function and through specialist advice from its national team. UKHSA also hosts the UK Advisory Panel for Healthcare Workers living with Bloodborne Viruses which provides advice about the transmission and management of bloodborne viruses among healthcare workers
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government further to the Written Statement by Lord Markham on 8 June (HLWS826), what assessment they have made of the incidence of HIV in (1) women, and (2) heterosexual men, between 2019 and 2021; and what steps they are taking to improve this.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The UK Health Security Agency is currently developing a methodology to estimate incidence among heterosexual men and women based on the methodology currently used to produce estimates of incidence for gay, bisexual and other men who have sex with men. As estimates of incidence are not available for heterosexual men and women, new diagnoses first made in the United Kingdom are used as a proxy and interpreted in context of levels of HIV testing amongst those populations.
Between 2019 and 2021, there was a slight increase in HIV diagnoses and late HIV diagnoses among heterosexuals, whilst HIV testing coverage remained substantially lower in 2021 than in 2019. In addition, the estimated number of undiagnosed people among heterosexual men and women did not decline over the same period. These figures suggest that there was no fall in incidence in this population.
The HIV Action Plan published in 2020 aims to reduce new HIV infections by 80% between 2019 and 2025 and details a range of actions committed to in order to help achieve this ambition.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the effectiveness of opt-out HIV testing in emergency departments in areas of London with high HIV prevalence.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
NHS England has committed £20 million in 2022 to 2025 to fund the expansion of HIV opt-out testing in emergency departments (EDs) in areas with extremely high HIV prevalence. The NHS England London region took a decision to include all EDs in the project, which included some of which were in high HIV prevalence areas.
Provisional data from NHS England indicates that this HIV opt-out testing initiative has helped find more than 550 cases of undiagnosed or untreated HIV in the first year of the programme. We are currently considering the results of the first year of HIV opt-out testing and the programme’s contribution to finding cases of undiagnosed or untreated HIV and preventing further HIV transmissions, alongside data on progress towards our ambitions to end new HIV transmissions, AIDS and HIV-related deaths within England by 2030.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether NHS England has set key performance indicators for integrated care boards or NHS Trusts to improve detection of osteoporotic fractures; and, in considering whether or not to set such key performance indicators, whether NHS England takes account of the risk that bone fractures can cause of premature death and disability.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
As part of the National Clinical Audit and Patient Outcomes Programme, the Healthcare Quality Improvement Partnership commission and manage a range of audits, including the Falls and Fragility Fracture Audit Programme. These collect and analyse data supplied by local clinicians to provide a national picture regarding care. The results can then be used by systems and trusts to focus quality improvement.
This programme audits against a range of key performance indicators informed by National Institute for Health and Care Excellence (NICE) technology assessments and guidance from the Royal Osteoporotic Society Clinical Standards. This includes those related to detection of osteoporotic fractures. There are also indicators related to osteoporosis and the prevention of fragility fractures within the Quality and Outcomes Framework.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they intend to encourage NHS England to designate osteoporosis as a ‘long term condition’.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Department continues to work with NHS England on musculoskeletal policy, including considering classification of conditions such as osteoporosis.
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the case for appointing (1) a National Clinical Director, or (2) National Specialty Adviser, for osteoporosis within NHS England.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Andrew Bennett is NHS England’s national clinical director for musculoskeletal conditions, which includes osteoporosis.