Hospital Dr News

Better standards of care needed for all ‘fragility’ fracture patients in the NHS, audit finds

A greater standard of care for all ‘fragility’ fracture patients is required despite more patients receiving a bone health check by a Fracture Liaison Service (FLS), an audit finds.

The RCP audit, called Leading FLS improvement: Secondary fracture prevention in the NHS, says there are more than half a million fragility fractures in the UK each year, including around 79,000 hip fractures, at a cost to the NHS of £4.3 billion a year.

Individuals over the age of 50 who experience fragility fractures, the majority of whom are post-menopausal women, are more likely to go on to suffer more serious bone breaks, such as hip fractures, as they age.

Nearly half of all fracture patients identified are seen by an FLS, although this remains variable depending on each service.

The audit found that 67% of patients were assessed by an FLS within 90 days.

This, however, varies widely depending on the NHS trust, with less than a quarter of FLSs able to assess over 95% of patients within 90 days. In comparison, a similar number (28%) of FLSs saw less than half of patients in the same time frame.

The report also finds:

  • There is a marked variability in the proportion of patients receiving recognised standards of car
  • More patients are receiving a falls assessment, now at 40% compared to the previous figure of 32%.
  • Only 41% of patients who were prescribed anti-osteoporosis medication were monitored by 12-16 weeks post fracture.

Dr Kassim Javaid, FLS-DB clinical lead, said: “Fragility fractures are very common in those over the age of 50, with the number of older people projected to experience a hip fracture expected to rise by 65% over the next 20 years.

“These fractures can be a potentially life-changing experience for those who suffer them and it is therefore hugely important that patients receive effective treatment and care to help ensure they do not suffer further fractures later on in life.

“Being able to potentially reduce the number of preventable fractures by over 50,000 would represent a substantial reduction in emergency admissions to our already overstretched hospitals and help to lessen the demand on social care at a time when these services have never been so pressured.”

See the FLS toolkit.

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