Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what actions they have taken in response to the Medical Research Council's UK primary care-based ‘Screening for Osteoporosis in Older People’ trial.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government has not taken any specific action in response to the Medical Research Council's primary care-based trial, Screening for Osteoporosis in Older People. However, there are actions that the Government is taking more generally, to support people with osteoporosis and increase early diagnosis.
The Government is working to set up 160 community diagnostic centres (CDCs) across the country by March 2024. Some of these CDCs will offer bone density scans which can be used to diagnose or assess patients’ risk of osteoporosis. Our ambition is that 95% of patients needing a diagnostic check will receive it within six weeks, by March 2025.
On 24 January 2023, we announced our plan to publish the Major Conditions Strategy. The strategy will focus on six major groups of conditions, including musculoskeletal (MSK) disorders such as osteoporosis. We have since published our initial report Major conditions strategy: case for change and our strategic framework, which is available on the GOV.UK website, in an online only format. For MSK conditions such as osteoporosis, it sets out our aims to improve services where medical treatment is necessary. Together with NHS England, we will explore supporting the further provision of fracture liaison services. This could include identifying people at risk of further osteoporotic fragility fractures and implementing strategies to reduce the risk of future fractures, including from falls, and mortality.
Valuable research work is also being funded by the Department, through the National Institute of Health and Care Research, which has awarded £173 million to research into MSK conditions in the last five years.
The UK National Screening Committee (UK NSC) last reviewed the evidence to screen for osteoporosis in postmenopausal women in 2019, recommending that a population screening programme should not be introduced. The review identified that there were key areas of uncertainty around the test and treatment and that further research was needed. The research showed that screening all women for osteoporosis does not reduce the number of fractures compared to current care.
The UK NSC can be alerted to any new published peer-reviewed evidence which may suggest the case for a new screening programme via its annual call, which will open in July 2024.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they are considering using the new screening technology, developed by OsteoSight, for estimating bone mineral density from routine X-rays that has been approved by the Food and Drug Administration in the United States to give earlier diagnosis of osteoporosis.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
OsteoSight is not a registered product with the Medicines and Healthcare Products Regulatory Agency, therefore the Government is not currently considering the use of this technology. However, we will continue to explore areas where artificial intelligence can be deployed in health and care to support clinicians, transform patient experience and improve outcomes.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to ask the Royal Osteoporosis Society to establish ‘lived experience’ focus groups for people with Osteoporosis to inform their Major Conditions Strategy; and what plans they have to include the issue of bone fractures in the Strategy.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Major Conditions Strategy will look to tackle the six major condition groups including musculoskeletal (MSK) conditions. In August 2023, we set out our initial plans in the online-only Major Conditions Strategy:Case for change and our strategic framework including that we will look to, together with NHS England, explore supporting the provision of fracture liaison services.
There are no current plans to ask the Royal Osteoporosis Society to establish ‘lived experience’ focus groups for people with Osteoporosis. However, the Department has worked closely with stakeholders to develop the Major Conditions Strategy including people with lived experience and organisations representing patients, carers, and conditions. This includes engagement with the Arthritis and Musculoskeletal Alliance, an umbrella body bringing together patient organisations and professional bodies representing the breadth of MSK health. The development of the strategy has also been informed by the Call for Evidence, which received over 400 responses from both individuals and organisations. Our intention is to publish the Major Conditions Strategy early this year.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of the potential cost savings to (1) the NHS, and (2) employers, in the next 20 years as a result of early detection and treatment of osteoporosis.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We have made no estimate of the potential cost savings to the National Health Service, and to employers, in the next 20 years as a result of early detection and treatment of osteoporosis.
Information on the number of working days lost each year that result from bone fractures is not available. The Office for National Statistics (ONS) Sickness absence in the United Kingdom labour market publication is produced from data collected from the Labour Force Survey; however, this survey does not specifically ask the question of sick days taken due to fractures.
A document is attached with tables showing, firstly, the number of deaths where bone fractures were the secondary cause of death, by broad age group and sex, registered between 2014 and 2023 in England and Wales; and secondly, the number of deaths involving bone fractures, by broad age group and sex, registered between 2014 and 2023 in England and Wales.
Government will continue to consider options for further work to support those with osteoporosis and at risk of fractures, including working together with NHS England to explore supporting the provision of fracture liaison service.
Asked by: Baroness Altmann (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimates they have made of the number of (1) deaths and (2) working days lost, each year that result from bone fractures among (a) women, and (b) men.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We have made no estimate of the potential cost savings to the National Health Service, and to employers, in the next 20 years as a result of early detection and treatment of osteoporosis.
Information on the number of working days lost each year that result from bone fractures is not available. The Office for National Statistics (ONS) Sickness absence in the United Kingdom labour market publication is produced from data collected from the Labour Force Survey; however, this survey does not specifically ask the question of sick days taken due to fractures.
A document is attached with tables showing, firstly, the number of deaths where bone fractures were the secondary cause of death, by broad age group and sex, registered between 2014 and 2023 in England and Wales; and secondly, the number of deaths involving bone fractures, by broad age group and sex, registered between 2014 and 2023 in England and Wales.
Government will continue to consider options for further work to support those with osteoporosis and at risk of fractures, including working together with NHS England to explore supporting the provision of fracture liaison service.
Asked by: Wera Hobhouse (Liberal Democrat - Bath)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the (a) referral and (b) risk assessment criteria will be for referring women to women’s health hubs in order to access Fracture Liaison Services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
In July 2023 we announced that the £25 million investment in women’s health hubs is being distributed to every integrated care board (ICB), with each ICB receiving £595,000 in total over 2023/24 and 2024/25. ICBs have been asked to use the funding to establish or expand one women’s health hub, including working with their local authority commissioners and within their system.
It is important that services are provided in a way that best meets population needs and reduces health inequalities, and ICBs will determine which specific services their hub will offer. To support ICBs to establish women’s health hubs, we have published a cost-benefit analysis, and a core specification. The core specification sets out which services ICBs could consider incorporating into their hub model, either in terms of provision or signposting. Osteoporosis assessment and care, for example DEXA (bone density) scanning or fracture liaison services is included in the core specification as an area for consideration.
Further information on women’s health hubs was published on GOV.UK in July 2023 at the following link:
https://www.gov.uk/government/collections/womens-health-hubs
Asked by: Wera Hobhouse (Liberal Democrat - Bath)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the referral pathways will be for women to access women’s health hubs in order to benefit from Fracture Liaison Services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
In July 2023 we announced that the £25 million investment in women’s health hubs is being distributed to every integrated care board (ICB), with each ICB receiving £595,000 in total over 2023/24 and 2024/25. ICBs have been asked to use the funding to establish or expand one women’s health hub, including working with their local authority commissioners and within their system.
It is important that services are provided in a way that best meets population needs and reduces health inequalities, and ICBs will determine which specific services their hub will offer. To support ICBs to establish women’s health hubs, we have published a cost-benefit analysis, and a core specification. The core specification sets out which services ICBs could consider incorporating into their hub model, either in terms of provision or signposting. Osteoporosis assessment and care, for example DEXA (bone density) scanning or fracture liaison services is included in the core specification as an area for consideration.
Further information on women’s health hubs was published on GOV.UK in July 2023 at the following link:
https://www.gov.uk/government/collections/womens-health-hubs
Asked by: Wera Hobhouse (Liberal Democrat - Bath)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the Government announcement of 8 March 2023, what proportion of the £25 million allocated for the creation of women’s health hubs will be invested in Fracture Liaison Services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
In July 2023 we announced that the £25 million investment in women’s health hubs is being distributed to every integrated care board (ICB), with each ICB receiving £595,000 in total over 2023/24 and 2024/25. ICBs have been asked to use the funding to establish or expand one women’s health hub, including working with their local authority commissioners and within their system.
It is important that services are provided in a way that best meets population needs and reduces health inequalities, and ICBs will determine which specific services their hub will offer. To support ICBs to establish women’s health hubs, we have published a cost-benefit analysis, and a core specification. The core specification sets out which services ICBs could consider incorporating into their hub model, either in terms of provision or signposting. Osteoporosis assessment and care, for example DEXA (bone density) scanning or fracture liaison services is included in the core specification as an area for consideration.
Further information on women’s health hubs was published on GOV.UK in July 2023 at the following link:
https://www.gov.uk/government/collections/womens-health-hubs
Asked by: Wera Hobhouse (Liberal Democrat - Bath)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what proportion of women’s health hubs will provide Fracture Liaison Services.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
In July 2023 we announced that the £25 million investment in women’s health hubs is being distributed to every integrated care board (ICB), with each ICB receiving £595,000 in total over 2023/24 and 2024/25. ICBs have been asked to use the funding to establish or expand one women’s health hub, including working with their local authority commissioners and within their system.
It is important that services are provided in a way that best meets population needs and reduces health inequalities, and ICBs will determine which specific services their hub will offer. To support ICBs to establish women’s health hubs, we have published a cost-benefit analysis, and a core specification. The core specification sets out which services ICBs could consider incorporating into their hub model, either in terms of provision or signposting. Osteoporosis assessment and care, for example DEXA (bone density) scanning or fracture liaison services is included in the core specification as an area for consideration.
Further information on women’s health hubs was published on GOV.UK in July 2023 at the following link:
https://www.gov.uk/government/collections/womens-health-hubs
Asked by: Lord Black of Brentwood (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether NHS England has set key performance indicators for integrated care boards or NHS Trusts to improve detection of osteoporotic fractures; and, in considering whether or not to set such key performance indicators, whether NHS England takes account of the risk that bone fractures can cause of premature death and disability.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
As part of the National Clinical Audit and Patient Outcomes Programme, the Healthcare Quality Improvement Partnership commission and manage a range of audits, including the Falls and Fragility Fracture Audit Programme. These collect and analyse data supplied by local clinicians to provide a national picture regarding care. The results can then be used by systems and trusts to focus quality improvement.
This programme audits against a range of key performance indicators informed by National Institute for Health and Care Excellence (NICE) technology assessments and guidance from the Royal Osteoporotic Society Clinical Standards. This includes those related to detection of osteoporotic fractures. There are also indicators related to osteoporosis and the prevention of fragility fractures within the Quality and Outcomes Framework.