Fracture Liaison Services

Lord Rennard Excerpts

Wednesday 4th December 2024 Lords Chamber

[Lord Rennard (LD)]

My Lords, it is a great pleasure to take part in a debate in which there is such strong consensus. The noble Lord, Lord Black of Brentwood, is again to be congratulated on raising this vital issue of fracture liaison services and asking the new Government about progress towards achieving the previous Government’s target of 100% coverage by 2030. In 2021 we were given the figure of 51%—or 63 out of 123—NHS trusts across England having fracture liaison services. There is now 100% coverage in Scotland, Wales and Northern Ireland, so it is disappointing if the figure is still the same 51% for England.

We have heard how osteoporosis affects 3.5 million people in the UK, causing more than half a million fractures each year, and that, according to the Royal Osteoporosis Society, two-thirds of the people who need treatment are missing out, leaving them vulnerable to further life-altering fractures—and we have heard how women are disproportionately affected. Both the Sunday Express and the Mail on Sunday have been mentioned for partnering with the Royal Osteoporosis Society to campaign for an end to the postcode lottery that leaves so many people without fracture liaison clinics.

The new Government have promised to roll out a plan to ensure that every part of the country has access to FLS. All the main parties in the general election promised this, but we have heard tonight that investment needs to be made now if the Government are to achieve the target by 2030.

We have heard how the Royal Osteoporosis Society has estimated that just a £30 million investment in fracture liaison services could prevent 74,000 fractures, including 31,000 hip fractures, over five years—but, we are all asking, will this expenditure take place and will it be soon? The issue of providing universal cover for fracture liaison clinics may not create such big headlines as those about cancer treatments or accident and emergency waiting times, but, as we have heard, the issue affects so very many people. The political will really must be there if we are to address the need to reduce the number of hip and other fractures.

I have always advised people that whichever party wins an election, the Treasury stays in power, and that the Treasury often adopts a very short-term approach demanding a rapid return on any investment. This approach needs to change across the health and care sector if we really want to move towards more prevention and needing less cure. As the noble Baroness, Lady Bull, said, fracture liaison services provide a relatively rapid return on that investment.

There are still considerable challenges. The clinical workload of those expected to undertake roles within the services is immense. Rheumatology services were hit enormously by Covid and years of underinvestment. We can work with multidisciplinary teams and new technologies such as AI in order to streamline care, improve efficiency and help clinicians to manage growing demand, achieving economies of scale, but technology alone is not the answer; we also need meaningful investment in preventive services.