Prevention is key to investing in osteoporosis services, but will Labour keep its promise?

One of the changes the new government wants is to make a shift from hospital to prevention. The case for investment into osteoporosis treatment is all about prevention. That’s because although it can be a life-threatening and life-limiting condition there are safe and effective medications and ways of treating it.

The problem is the investment in services for assessment, monitoring and treatment is just not there, with two out of three patients not getting access to the medication they need.

This is a disgrace because:

• Five people die every day from broken bones that could’ve been prevented.
• Half of all women over 50 and a fifth of all men will break a bone due to Osteoporosis.
• Osteoporosis is the fourth worse cause of disability and preventable death in the UK and the second biggest filler of hospital beds.

With such stark statistics, an All-Party Parliamentary group (APPG) that was investigating osteoporosis services made a pledge to introduce Fracture Liaison Services (FLS) in England by 2030. This pledge was recently confirmed by health secretary Wes Streeting at the Labour Party conference in Liverpool, as it was during the election campaign.

Although that confirmation was welcome, campaigners have a degree of scepticism. That’s because in recent years despite cross-party support, investment has been blocked with delay after delay.

The Royal Osteoporosis Society: Labour must invest

Indeed, this is why osteoporosis campaigners such as the Royal Osteoporosis Society (ROS) are looking to this Budget to see if the health secretary’s confirmation has ‘transformed’ into the investment needed to provide these crucial services.

Without this investment there are two key problems those who might have osteoporosis face.

The first problem – diagnosis – is the difficulty in getting a bone density scan (DXA scan). This scan uses low dose x-rays to see how strong/dense the bones are.

When osteoporosis is suspected in a person over 50 and/or they present with a fragility fracture, that is a fracture from a fall from standing height or less, then they should be referred for a DXA scan.

But the waiting times for a DXA scans were found by the APPG in 2023 to be “wildly disproportionate” compared to other types of scans like an MRI or ultrasound. This is mainly due to the numbers of scanners available, with Britain having one of the lowest amounts of scanners compared to other European countries.

This has a huge impact. In areas with limited access, it can take a lengthy journey just to get a scan.  This might be too much for some to manage. Others might try to ‘go private’ but this can then lead to problems, especially if NHS treatment is sought later in their treatment and care.

A lack of joined-up prevention and care

The second problem is the lack of joined-up care in the form of Fracture Liaison Services (FLS)

These services would be for those suspected of having Osteoporosis who had already broken a bone. Here they would have access to medication and bone density (DXA) scans in a timely manner to help prevent them from sustaining secondary fractures.

The prevention of these fractures comes with cost-benefit too. For example, with FLS services across England, the Royal Osteoporosis Society says 74,000 fractures, including 31,000 hip fractures, could be prevented over five years. This would release 750,000 bed days saving the NHS £665 million.

A FLS would’ve helped Joy, a teacher in her early 40’s, working in a large secondary school. She had a bad fall at work, sustaining a nudge fracture in her spine. But rather than being referred for a DXA scan she was sent to the fracture clinic.

Joy said:

I was discharged from the fracture clinic, and it was only when I saw a new GP for a routine appointment that osteoporosis and DXA scans were mentioned. She referred me for a scan that took about 3 months. But while I was waiting, she gave me medication for Osteoporosis, just in case.

When Joy eventually got her scan results it confirmed she had Osteoporosis with evidence of past healed and partially healed broken bones. Joy said

I wish I’d known earlier. I would’ve done so much to change things.

There is a general lack of knowledge about osteoporosis and the steps we can all take to help protect our bone health. 

A groundbreaking risk checker

To help change that, the Royal Osteoporosis Society has developed a groundbreaking tool for anyone who thinks they may have or be at risk of having the condition. The osteoporosis risk checker is at www.theros.org.uk

As we can see prevention is key to osteoporosis because there are treatments and ways of working that could help this picture, saving needless suffering to those with the condition, and saving the NHS money.

So, why has there been so little political action in getting FLS services set up?

ROS volunteer, and leader of the ‘Better Bones’ campaign (a collaboration between the ROS and Sunday Express) Annette Browne said:

This has felt like a deadly game of snakes and ladders. Leaders from all parties agreed weeks into our campaign that everybody should have these diagnostic clinics. But for 18 months there’s been buck-passing between departments in Whitehall over who should pay.

We are now begging the Government to end the needless pain and misery of osteoporosis, and finally stop the two years of Whitehall buck-passing that has denied 90,000 people the bone medication they need to avoid life-threatening injuries.

Osteoporosis patients are ‘putting their trust’ in Labour

 Craig Jones, CEO of the Royal Osteoporosis Society, said:

We’re putting our trust in the Health Secretary to stop history repeating itself in the Budget. Otherwise, we’ll have another year of paralysis, where people are left to shatter bones after coughs and sneezes, even though we have safe, cheap medication stacking up on pharmacy shelves which can give them their lives back.

With preventative work being at the heart of the approach to the NHS, it’s hard to see how this Labour government could fail to invest in Fracture Liaison Services, due to the cost-benefits to the NHS long-term and in terms of treating people in a timely manner enabling them to return to the workplace.

But with pre-announced Treasury pressures, and jitters, there’s an anxious wait to see what actually transpires come Autumn Budget Day.

The Royal Osteoporosis Society has a lot more information on Osteoporosis and can be found here: https://theros.org.uk/information-and-support/

Featured image via the Canary