Fracture Liaison Services

Lord Rennard Excerpts

Thursday 16th October 2025 Grand Committee

[Lord Rennard (LD)]

My Lords, I too welcome the persistent, skilful and incredibly determined approach of the noble Lord, Lord Black of Brentwood, to achieve what is clearly needed—that is, the expansion of the use of fracture liaison services to 100% coverage by 2030. This commitment, contained in the 10-year health plan, is the right goal.

When we consider the issues around osteoporosis, we are discussing a public health crisis. Osteoporosis is a condition that is asymptomatic until fragility fractures strike. These fractures are painful. They can lead to social isolation and a significant loss of mobility and independence, and too often to mental health conditions such as depression. Osteoporosis-related fractures claim as many lives as lung cancer or diabetes. They rank as the second highest cause of bed occupancy within the NHS. We all know how expensive the occupancy of hospital beds is and we are aware of the dangers to many patients of being in hospital. These include the risk of infections, sometimes as serious as sepsis.

We need to try to act further to avoid fractures and the resulting stays in hospital. Fracture liaison services proactively identify patients aged 50 and over with a fracture, assessing their bone health and their falls risk to try to prevent what may be a devastating subsequent fracture. We have heard for many years about the laudable ambition of achieving 100% FLS coverage in England by 2030, but we may fail to achieve that target if we fail to heed the lessons from Wales, where they have achieved that goal.

The Government’s current commitment to action is not as rapid as that which has already been achieved in Wales. In February 2023, the then Welsh Health Minister, the noble Baroness, Lady Morgan of Ely, issued a decisive national mandate. She instructed all health boards to establish fracture liaison services within 18 months, backed by pump-priming investment. By September 2024, the target was met and every acute health board in Wales had a functioning service.

The Welsh Government then committed to achieving international quality standards by 2030. That will mean ensuring that these services are resourced to serve at least 80% of the over-50s. The Welsh Government faced the same hurdles that England faces—the same financial pressures, the same workforce challenges and the same competing priorities—but the difference was urgency and focus. In England, without national co-ordination, commissioners are recognising the value of FLS, but they appear to be waiting for direction before committing scarce resources. The result, as we have heard, is that England now runs the risk of falling behind the rest of the UK in osteoporosis care. We must not let that happen.