FLS audit calls for greater standard of care for all ‘fragility’ fracture patients

A new report from the Royal College of Physicians (RCP) has found that while more fracture patients are receiving bone health checks from Fracture Liaison Services (FLS), a greater standard of care for all ‘fragility’ fracture patients is required.

Leading FLS improvement: Secondary fracture prevention in the NHS, published by the RCP’s Falls, Fragility and Fracture Audit Programme (FFFAP), added that despite fracture liaison services (FLSs) being an effective way to prevent further fragility fractures, access to an FLS and the quality of care provided depends too much on where a patient lives.

The report’s findings include:

  • 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.
  • National coverage of secondary fracture prevention using FLS remains low with around just a third of all acute trusts participating. The majority of trusts that did not provide data do not have a FLS, contributing further to the regional variance in care a patient can receive.
  • CCGs and LHBs without an FLS should actively work with their local NHS staff to develop fund and implement a service.

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. It would also provide a huge benefit for patients and their families and carers in reducing the stress and suffering that fractures so often cause. We have an opportunity to close this gap in bone health care and we should work together to achieve it.

Claire Severgini, National Osteoporosis Society chief executive said:

We hear far too often from people with osteoporosis about the devastating effects fractures have on their lives and their families, and it is vital that we place the prevention of fragility fractures as an absolute priority for all health services.

The work of the FLS-DB is very important in showing the many benefits of having a properly integrated fracture liaison service. Receiving great care should not depend on where you live and more work needs to be done in extending coverage of FLSs across the country.