Fracture Liaison Services

Lord Lexden Excerpts

Thursday 16th October 2025 Grand Committee

[Lord Lexden (Con)]

My Lords, my noble friend Lord Black is, thankfully, a persistent person. The subject we are discussing today is one that he has brought before your Lordships with some frequency, through debates and Oral Questions. Those who suffer the pain and distress that osteoporosis brings have no more determined parliamentary champion than him. Evidence continues to accumulate in support of the action for which he has long called and which he has reiterated so powerfully today: the urgent need to establish fracture liaison services throughout our country.

For some years the Royal College of Physicians has charted a steady rise in the number of hip fractures. Its latest annual report, published last month, records yet another increase. It also shows, once again, how unevenly the services that could reverse this trend are spread across our country. Indeed, there could be no clearer example of that much-reviled phenomenon: the postcode lottery.

Curiously, there seems to be no figure for the total number of hip fractures in the United Kingdom. Scotland appears disinclined to share information. In the other three parts of the country the total now stands at some 70,000. Without the action for which my noble friend Lord Black is calling, the number will go on mounting remorselessly. Experts believe that it will double by 2060, bringing the total to 140,000. The bill will be crippling. Today each hip fracture costs the health and care services around £28,000. Total expenditure, which now stands at some £2 billion, is likely to reach £3.8 billion by 2060—virtually doubling the huge burden borne by our overstretched NHS.

The burden can and must be reduced. The key to this is to ensure that those who incur smaller, less severe fractures are correctly diagnosed as suffering from osteoporosis and are treated accordingly. That would cut the number of hip fractures dramatically, but it will not happen without the major change for which my noble friend Lord Black and others have long been pressing. At the moment, around half of those who break a hip have experienced an earlier, less severe fracture without being correctly diagnosed and treated. That means that tens of thousands of people are being discharged from hospital at severe risk of hip fracture and, in due course, some of them will suffer one. More than one in four of those who have a hip fracture will die within a year.

No one, I think, disputes that the most effective way this state of affairs can be remedied is through the provision of fracture liaison services which identify and treat people after their first fracture, helping to prevent a second. Yet, as we have heard, only around half of NHS trusts provide such a service. Like everyone —I think—taking part in this debate, I hope the Government, who have shown that they understand the need for urgent action, will publish before Christmas their plan to extend fracture liaison services throughout the country.