Asked by: Julian Sturdy (Conservative - York Outer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential (a) cost-effectiveness and (b) efficiency gains of maintaining Fracture Liaison Services to local NHS and care services; and whether his Department is taking steps to assist Vale of York CCG and York Hospital Trust to establish a Fracture Liaison Service for York.
Answered by Gillian Keegan - Secretary of State for Education
Services for those with osteoporosis and bone health conditions, including Fracture Liaison Services (FLS), are commissioned locally. NHS England is working with local integrated care systems (ICSs) to support the implementation of FLS and increase the number of clinics. NHS England is also developing regional bone health clinical networks to support clinicians working in FLS. The Department expects musculoskeletal, fragility fracture and fall services to be fully incorporated into ICSs’ planning, informed by the metrics available on the Model Health System (MHS) platform. NHS England has worked with the Healthcare Quality Improvement Partnership and the Royal College of Physicians, to ensure key performance indicators from the Falls and Fragility Fracture Audit Programme are included within the MHS.
No specific assessment has been made of the potential for cost-effectiveness or efficiency gains of maintaining FLS or the establishment of a service in York.
Asked by: Julian Sturdy (Conservative - York Outer)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assistance his Department provides (a) Clinical Commissioning Groups and (b) Hospital Trusts to (i) operate Fracture Liaison Services and (ii) contribute to the Falls and Fragility Fracture Audit Programme; and if his Department will take steps to assist Vale of York CCG and York Hospital Trust to establish a Fracture Liaison Service for York.
Answered by Gillian Keegan - Secretary of State for Education
Services for those with osteoporosis and bone health conditions, including Fracture Liaison Services (FLS), are commissioned locally. NHS England is working with local integrated care systems (ICSs) to support the implementation of FLS and increase the number of clinics. NHS England is also developing regional bone health clinical networks to support clinicians working in FLS. The Department expects musculoskeletal, fragility fracture and fall services to be fully incorporated into ICSs’ planning, informed by the metrics available on the Model Health System (MHS) platform. NHS England has worked with the Healthcare Quality Improvement Partnership and the Royal College of Physicians, to ensure key performance indicators from the Falls and Fragility Fracture Audit Programme are included within the MHS.
No specific assessment has been made of the potential for cost-effectiveness or efficiency gains of maintaining FLS or the establishment of a service in York.
Asked by: Zarah Sultana (Labour - Coventry South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to ensure universal access to fracture liaison services; and what recent assessment his Department has made of the impact of the absence of universal service availability on the health of those with osteoporosis and bone health conditions.
Answered by Gillian Keegan - Secretary of State for Education
We are currently assessing the accessibility of fracture liaison services (FLS) through data collected in the national Falls and Fragility Fracture Audit Programme. This aims to identify any inequitable provision and improve services.
Services for those with osteoporosis and bone health conditions are commissioned locally. The Department expects musculoskeletal, fragility fracture and fall services to be fully incorporated into integrated care systems’ planning and decision-making. This will allow greater collaboration, improve the coverage and sustainability of services and development of regional bone health clinical networks to support clinicians working in FLS.
Asked by: Nadia Whittome (Labour - Nottingham East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to ensure that specialised training is provided to emergency services on providing emergency care to people with osteoporosis.
Answered by Edward Argar - Minister of State (Ministry of Justice)
Health Education England (HEE) provides a range of technology enhanced programmes on osteoporosis which are available to all healthcare staff. The paramedics e-learning programme also includes specific training on osteoporosis.
HEE will be making funding available in 2022/23 to support National Health Service trusts to provide advanced and enhanced-level training to all allied health professionals, including diagnostic radiographers, to support bone density scan training. It is the responsibility of individual NHS trusts to invest in post-registration training to increase the number of staff trained to undertake DEXA scans.
Asked by: Nadia Whittome (Labour - Nottingham East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans his Department plans to provide training to NHS staff on specific care for people with osteoporosis.
Answered by Edward Argar - Minister of State (Ministry of Justice)
Health Education England (HEE) provides a range of technology enhanced programmes on osteoporosis which are available to all healthcare staff. The paramedics e-learning programme also includes specific training on osteoporosis.
HEE will be making funding available in 2022/23 to support National Health Service trusts to provide advanced and enhanced-level training to all allied health professionals, including diagnostic radiographers, to support bone density scan training. It is the responsibility of individual NHS trusts to invest in post-registration training to increase the number of staff trained to undertake DEXA scans.
Asked by: Nadia Whittome (Labour - Nottingham East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will provide more funding to train healthcare professionals in using Bone density scans (DEXA) for patients with osteoporosis.
Answered by Edward Argar - Minister of State (Ministry of Justice)
Health Education England (HEE) provides a range of technology enhanced programmes on osteoporosis which are available to all healthcare staff. The paramedics e-learning programme also includes specific training on osteoporosis.
HEE will be making funding available in 2022/23 to support National Health Service trusts to provide advanced and enhanced-level training to all allied health professionals, including diagnostic radiographers, to support bone density scan training. It is the responsibility of individual NHS trusts to invest in post-registration training to increase the number of staff trained to undertake DEXA scans.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether medical guidelines encourage medical professionals to recommend all people over the age of 50 who suffer a bone fracture to be scanned for osteoporosis.
Answered by Gillian Keegan - Secretary of State for Education
The National Institute for Health and Care Excellence (NICE) has published best practice clinical guidance on assessing and managing the risk of fragility fractures in people aged 18 years old and over with osteoporosis. The guidance recommends considering assessment of fracture risk in women aged under 65 years old and men aged under 75 years old in the presence of risk factors, such as a previous fragility fracture. The guidance, ‘Osteoporosis: assessing the risk of fragility fracture’, is available at the following link:
NICE guidelines represent best practice and health and care professionals, including commissioners, are expected to take them fully into account in their decisions. However, these guidelines are not mandatory and do not replace the judgement of clinicians in determining the most appropriate treatment for individual patients.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he will take with relevant medical professionals to assess the potential merits of using bone scans to (a) diagnose the risk of (b) adequately treat bone fractures.
Answered by Gillian Keegan - Secretary of State for Education
The RightCare Falls and Fragility Fractures Pathway was developed in 2017 in collaboration with professionals from with the National Health Service, Public Health England, the National Osteoporosis Society and others to provide commissioners with resources to prevent falls, detect and manage osteoporosis, and support people after having fragility fractures.
The Pathway recommends screening for people with higher risk of fractures due to old age and known health diseases, specifying bone scans as a screening tool. The scans help to diagnose osteoporosis in bones which indicates a risk of fracture as the bone is weakened. The benefits of using follow up bone scans when treating a known fracture can show if the bones have weakened further. The results help to manage the patient appropriately in the care pathway. NHS England and NHS Improvement are planning to refresh the toolkit in partnership with the BestMSK Pathway Improvement Programme within the next 12 months.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will commit to (a) developing a national bone denisity and osteoporosis screening service and (b) assessing the potential merits of piloting such a service as part of integrated care systems.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Recommendations for screening programmes are made by the United Kingdom National Screening Committee (UK NSC), an independent advisory committee. Recommendations on whether to screen for a particular condition are taken following a rigorous review process and based on the best evidence available.
The UK NSC has considered screening postmenopausal women for osteoporosis previously, but did not recommend a screening programme. The UK NSC will review the evidence in 2022/23.
Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to ensure adequate succession planning within the NHS for (1) osteoporosis, and (2) bone health specialists.
Answered by Lord Bethell
Individual National Health Service trusts are responsible for ensuring staffing arrangements are in place which deliver safe and effective care, including succession planning.
Osteoporosis and other bone health conditions are treated by a range of healthcare professionals, such as general practitioners (GPs), endocrinologists, rheumatologists and orthopaedic surgeons. Since 2010, the number of endocrinologists has increased by over 58%, rheumatologists by over 29% and trauma and orthopaedic surgeons by over 24%. We also have over 900 more full-time equivalent GPs March 2021, compared to March 2020. We continue to monitor the NHS’s workforce requirements and ensure that the NHS has the staff that it needs, including for the treatment of osteoporosis and bone health.