Fracture Liaison Services

Baroness Blake of Leeds Excerpts

Thursday 16th October 2025 Grand Committee

[Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)]

My Lords, I congratulate the noble Lord, Lord Black, on securing this important debate and thank all noble Lords for their significant contributions. I pay tribute to his personal background; it has brought such depth and strength of feeling to the subject, and I am sure many noble Lords have similar experiences. His persistence in carrying on with this is noted and welcomed. He is right to highlight the importance of reducing waiting lists, driving economic growth and safeguarding the most vulnerable members of our society.

We know that patients, including those with osteoporosis fragility fractures, are waiting too long for care and treatment, which needs to change, as I think all noble Lords have mentioned. This is why, between July 2024 and August 2025, the NHS provided more than 682,000 DEXA scans to patients across the country. As announced earlier this year, we are investing in 13 DEXA scanners to support improvements in early diagnosis and bone health and provide an estimated 29,000 extra scans a year once operational. I completely understand the points in the noble Lord’s speech about the need for follow-up action once the scans have been implemented.

I shall pick up the comments made by my noble friends Lady Royall and Lady Hayter. I think there is an enormous recognition of the need to focus on women’s health; that is an accepted aspect of all the work that we are doing. More generally, we want every person, including those with osteoporosis, to receive the highest quality compassionate care. In the past three years, two new drugs have been recommended by the National Institute for Health and Care Excellence for the treatment of osteoporosis in postmenopausal women, for example. Going back to women’s health, through our 10-year health plan and the women’s health strategy update, we are delivering our manifesto commitment that never again will women’s health be neglected.

The three shifts that I will go on to talk about—hospital to community, analogue to digital and treatment to prevention—are key aspects of the work that we need to do. Following from that, the 10-year workforce plan will ensure that the NHS will have the right people in the right places with the right skills to care for patients when they need it. That is a critical aspect. I will write to my noble friend Lady Royall with the more specific detail, if that is okay.

As the noble Lord, Lord Black, illustrated so powerfully, fracture liaison services can play a vital role in reducing the risk of refracture, improving the quality of life and increasing the years lived in good health. This Government and NHS England support the clinical case for services that help to prevent fragility fractures and support patients who sustain them. As we have heard, we are committed to rolling out fracture liaison services to every part of the country by 2030. As my noble friend Lady Hayter said, this is a genuine commitment. One of the early priorities of the 10-year plan will be a modern service framework for fragility and dementia. This is the first time that this has been introduced.

Going back to the 10-year plan, it is absolutely critical that we provide better care for people with osteoporosis, fragility fractures and other MSK conditions. The noble Lord, Lord Rennard, mentioned the problems with public health that we all know—as a former local government leader I know them only too well. Supporting the shift to prevention, the health system is working to prevent fractures occurring in the first place. Advice from NICE for clinicians includes information and advice on lifestyle changes a person can make to reduce their risk of fragility fracture, which the noble Earl, Lord Effingham, mentioned. These include increasing vitamin D intake, eating a balanced diet, drinking alcohol in moderation, stopping smoking if applicable and participating in a combination of exercise types. These are all absolutely fundamental in working towards the prevention agenda.

We are working to deliver the Getting It Right First Time MSK community delivery programme. The specific teams in this area are working with integrated care board leaders to reduce community waiting times and improve data, metrics and referral pathways to wider support services. Under the 10-year health plan, patients with MSK conditions will soon be able to bypass their GPs and directly access community services, including physiotherapy, pain management and orthopaedics, via the NHS app.

Our vision for a neighbourhood health service is also core to achieving the three shifts. The Department of Health and Social Care and NHS England are working closely together to progress our commitment to shift to a neighbourhood health service. The 10-year plan includes fracture liaison services as a specific example of the services that neighbourhood health centres could host.

As we have heard, fracture liaison services are commissioned by integrated care boards, which we believe are well placed to make decisions according to local need. This Government are committed to giving integrated care boards the freedom and autonomy they need to focus on the job of meeting patients’ needs and improving the communities they serve. I am pleased to say that 41 out of the 42 ICBs have a women’s hub. We need to make sure that they are delivering in this space.

Officials in the Department of Health and Social Care are working closely with NHS England to consider a range of options to ensure the improved quality of and access to these important preventive services. We need to be honest about the scale of the action needed, the challenges faced across the health and care system and the fact that change will not be possible overnight.

I recognise that many are dedicated to campaigning for fracture liaison service expansion. I thank the noble Lord, other contributors to this debate and the All-Party Parliamentary Group on Osteoporosis and Bone Health for its work. It is absolutely critical that we raise awareness of this vital issue and try not to wait until it is too late and a fracture has occurred. This is a very important aspect of the work that everyone is pulling together. I thank the clinicians and commissioning bodies that play such a vital role in delivering fracture liaison services.

In response to the noble Baroness, Lady Chisholm, on this point, we talk about politicians, but over the past year, officials, including senior civil servants, have engaged on various occasions with the Royal Osteoporosis Society on fracture liaison services, and they will continue to do so.

I do not have time to respond to all the comments, but I will pass on the comments of the noble Lord, Lord Shinkwin, to the Secretary of State. I thank him for his very clear exposition of his experience. I also undertake to pass on the comments of the noble Baroness, Lady Royall.

I close by simply restating the Government’s commitment to ensuring access to care where and when it is needed. Once again, I thank noble Lords for today’s discussion on such an important topic.

[The Deputy Chairman of Committees (Lord Haskel) (Lab)]

My Lords, I am sure we all thank the speakers for their brevity in reaction to the technical issues.