Osteoporosis

Will Quince Excerpts

Thursday 26th October 2023 Commons Chamber

[The Minister for Health and Secondary Care (Will Quince)]

I commend the hon. Member for Bradford South (Judith Cummins) for bringing this issue to the House’s attention. As chair of the all-party parliamentary group on osteoporosis and bone health, she has long been a champion for those with osteoporosis. She will know that many of the points raised today echo arguments made in the other place only last month. As ever, she articulately and eloquently made a powerful and persuasive case, and I very much look forward to working with her and the charities that specialise in this area to improve service provision and support for those with osteoporosis.

As the hon. Lady set out in her speech, osteoporosis represents a growing challenge in this country as our demographics shift, particularly for older people. It is estimated that in the UK more than 3 million people have osteoporosis, including approximately one in 10 women aged 60 and one in five women aged 70, with more than 500,000 fragility fractures occurring each year. As she rightly pointed out, this silent disease does not just affect older people. Many people of working age suffer preventable fractures, with an estimated 2.6 million sick days taken every year in the UK due to osteoporotic fractures. Studies suggest that over 22% of the population aged 50 to 64 will suffer a fracture.

Impassioned calls have been made of late for increased Government support for FLS, both within Parliament, not least from the hon. Lady, and in the media. I thank colleagues across both Houses and the Sunday Express, which has led on this issue, for helping to raise the profile of these important services, which have long been recognised as best practice for secondary fracture prevention by both the Department of Health and Social Care and NHS England. Indeed, in our “Major Conditions Strategy: A case for change and strategic framework”, published this summer, we made it clear that we would continue to explore supporting the provision of FLS.

As the hon. Lady will know—indeed, she raised this in her speech—fracture liaison services are locally commissioned. My hon. Friend the Member for Southend West (Anna Firth) rightly pointed out, first in her intervention and then in her short speech, the importance of FLS. I thank her for drawing attention to and championing the service in Southend, which is an exemplar that we hope other integrated care boards will follow.

For local systems requesting support to review and improve their secondary fracture prevention pathways, NHS England is producing system-level data packs, which include data from a variety of sources. That includes the FLS database to highlight where there may be unwarranted variation; the impact of, and upon, existing health inequalities, which we should always be concerned about; and where there are opportunities for transformation. The Royal Osteoporosis Society outlines that, for every £1 spent on FLS in the UK, the taxpayer can expect to save £3.28. So by levelling up provision to cover everyone over the age of 50, we could prevent just under 5,700 fragility fractures every year. If that is the case, it is only right that NHS England continues to support ICBs to develop their secondary fracture prevention services. As the hon. Lady rightly pointed out, the benefits are clear and I trust that commissioners will be exploring how best to support the needs of their patients in this important area.

The major conditions strategy is not the only headline workstream that we are taking forward to improve osteoporosis care. The first ever Government-led “Women’s Health Strategy for England” was published in July 2022, marking a reset in the way in which the Government are looking at women’s health. As part of that work, we are investing £25 million in women’s health hubs, with each ICB set to receive £595,000 over the current and next financial year to establish a women’s health hub within their system. As we have outlined in the women’s health hubs core specification, specific services will vary depending on population health needs, the existing set-up of services and the workforce skills in a local area. The core specification outlines osteoporosis assessment and care. For example—the hon. Lady rightly alluded to this —DEXA bone density scanning or FLS are areas that local systems could consider when establishing their hub.

As important as FLS is, it is not the only way in which we can ensure that people with osteoporosis receive the care they need. NHS England’s “Getting it Right First Time” programme has a specific workstream on musculoskeletal health and is exploring how best to support integrated care systems in the diagnosis and treatment of osteoporosis. There is also, alongside that, a range of NICE guidelines to support equity of care for people with osteoporosis, which healthcare professionals and commissioners should absolutely note.

As we know, the economic burden of fragility fractures can be significant. That is why in this year’s spring Budget we announced a package of measures to support individuals at risk of, or experiencing, musculoskeletal conditions to live and work well. Those include: making best use of digital health technologies to support people to better manage symptoms and increase mobility; designing and scaling up MSK community hubs, expanding access to community-based services delivering physical activity interventions; and alongside that, integrating employment advisers into musculoskeletal pathways, building on the success of the NHS talking therapies programme.

Finally, I would like to highlight some of the exciting work that we are supporting on the future of osteoporosis care, and that is about research. Valuable research into MSK conditions such as osteoporosis is being funded by the Department of Health and Social Care, through the National Institute of Health and Care Research. NIHR has awarded £173 million for research into MSK conditions in the last five years. That includes studies into understanding and improving patient experience of diagnosis for vertebral fracture, physiotherapy rehabilitation for osteoporotic vertebral fracture and other treatments for MSK conditions.

In addition, in 2021-22 alone over £30 million has been spent on NIHR infrastructure supported studies and, alongside that, trials into MSK conditions, and six of the NIHR biomedical research centres have MSK conditions as a research theme. NIHR, in collaboration with Versus Arthritis—I referenced earlier some of the fantastic charities working in this space—also funds a dedicated UK musculoskeletal translational research collaboration, which aligns investment in MSK translational research and creates a UK-wide ambition and alongside that a focus to drive cutting-edge research and improve outcomes for patients.

I do not for a second underestimate how painful and debilitating this silent disease is, but I am confident that real advances have been made. I know that we have further to go, but I am confident that, working together, such advances will continue to be made.

This Government are committed to improving the provision of osteoporosis treatment and support. I once again extend my sincere thanks to the hon. Lady for bringing forward this really important debate, and I especially thank the individuals, and indeed the charities and other organisations, who do so much to support people with osteoporosis.