Two million reasons to commission a Fracture Liaison Service

Older people who have broken a bone are twice as likely to break another, causing significant impacts physically mentally and financially. Bonnie Wiles looks at how a fracture liaison service can help prevent this from happening.

The Fracture Liaison Service Database's new Commissioner's report showed that local NHS Trusts can save £2.1million by preventing older people who have already broken a bone from breaking another. This is a significant amount of money at a time the NHS is increasingly stretched, and can have positive, life-altering benefits for patients. So how can you prevent a broken bone and save your trust millions of pounds?

The answer is a fracture liaison service (FLS).

What is a fracture liaison service?

FLSs are teams of nurses, doctors, therapists and administrative staff who treat people (usually aged 50 and over) with fractures to reduce the chance of experiencing another broken bone. This is called secondary fracture prevention (ie preventing the second fracture). Patients who have suffered a fragility fracture are at higher risk of breaking another bone; either the same bone again or another bone in the body.

There are an estimated half a million fragility fractures (a broken bone that happens after a fall from a standing height or less) in the UK each year, many of which could be prevented with earlier diagnosis. Osteoporosis is a condition that weakens bones, making them fragile and more likely to break. However, the link is not being made between fractures in the over 50s and undetected osteoporosis.

What can you save?

Figures show that prevention of fragility fractures through an effective FLS produces local savings to the NHS and social care of £2.1million over 5 years for a service cost of around £640,000 - a net benefit of £1.46 million.

You can find out your local saving through the Royal Osteoporosis Society’s (ROSs) benefits calculator.

How can you commission a FLS?

With the support provided from the ROS, commissioning and implementing an FLS could not be easier. You can follow the ROS implementation toolkit for templates and support on building a business case. A team of specialist Service Delivery Leads, all of whom have clinical or NHS commissioning experience, provide bespoke support to provider and commissioning partners. This includes consultation and guidance at every step of the process from clinical pathway development to gaining successful funding of services and training of staff to patient education. 

Find out whether patients in your clinical commissioning group (CCG) are being seen by an FLS from the 2019 report. An implemented FLS can participate in the Fracture Liaison Service Database (FLS-DB). The FLS-DB is a clinically-led web-based national audit of secondary fracture prevention in England and Wales. Those FLSs participating have publicly available run charts to support local quality improvement and measurement against national statistics. As well as annual reports, giving an overview of the local and national results.

Suffering a broken bone can be devastating for an older person. It increases the likelihood of feeling socially isolated, creates a significant financial burden and can make an older person more likely to go into a care home. Clearly, there is a need to help patients, and to make use of services that benefit both patients and the NHS. Fracture liaison services do all of this – so if your Trust isn’t connected to one already, why not?

Bonnie Wiles is a project manager for the RCP's Falls and Fragility Fracture Audit Programme