Question to the Department of Health and Social Care:

To ask Her Majesty's Government whether they intend to ensure that women over 60 years old are routinely offered bone density scans to ascertain bone health.

Fracture liaison services (FLS) provide secondary prevention for fragility fractures. These services identify patients in secondary and/or primary care who have suffered a fragility fracture and assess the patient’s risk of future fragility fracture in a timely fashion. A FLS then provides advice and/or therapy to reduce that risk.

The National Institute for Health and Care Excellence (NICE) evidence based guideline Osteoporosis: assessing the risk of fragility fracture, updated in February 2017, sets out best practice on management of fracture risk in patients with osteoporosis. A copy of the guideline is attached. The guidance recommends that clinicians consider assessment of fracture risk in all women aged 65 years and over and all men aged 75 years and over. Women aged less than 65 years and men aged less than 75 years should be considered for assessment in the presence of certain risk factors, such as a family history of hip fracture or low body mass index.

Regarding bone density scanning, NICE recommends it be considered after patients have first been assessed using a validated risk assessment tool, such as FRAX, which clinicians can use to evaluate the 10-year probability of bone fracture risk in patient. The guidance also recommends other circumstances where bone density scanning should be considered, including for patients who are to undergo treatment which may affect bone density, such as certain treatments for breast or prostate cancer.