Audit of fracture liaison services finds ‘marked variability’ in patient care

05 Mar 2018

Improvements are required in the standard of care for patients with fragility fractures, according to a new report.

Fracture Liaison Services (FLS) - services which systematically identify people at risk of osteoporosis - provide more fracture patients with access to bone health checks and are effective in preventing further fragility fractures, the report from the Royal College of Physicians said.

However, the audit also found marked variability in access to and the quality of care provided by these services, depending on where patients lived.

The audit is the first annual review into identification, assessment, treatment and monitoring of patients over 50 who have experienced a fragility fracture - fractures occurring as a result of normal activities, such as a fall from standing height or less.

The review measured services against guidance and standards set by the National Osteoporosis Society and the National Institute for Health and Care Excellence (NICE).

Less than a quarter of FLS were able to assess over 95% of patients within 90 days, and 28% of FLS saw less than half of patients in the same time frame. Only 41% of patients who were prescribed anti-osteoporosis medication were monitored by 12-16 weeks post fracture.

More positively, the report found 40% of patients were now receiving a falls assessment across all fracture liaison services, compared to the previous figure of 32% from 2010.

Authors of the report said more work is needed to improve monitoring, and called on clinical commissioning groups without an FLS to “actively” work with local NHS staff to develop, fund and implement a service.

The National Osteoporosis Society works in partnership with the NHS to set up and improve FLS, to identify people at risk of osteoporosis and start them on a treatment pathway to prevent future broken bones.

Fizz Thompson, Clinical Director at the National Osteoporosis Society, said: “Hip fractures caused by osteoporosis are affecting more people and costing our overstretched health service more money every year.”

“The National Osteoporosis Society has long been a champion of the role fracture liaison services can play in addressing this problem,” said Ms Thompson.

“This new report will do a great deal to help individual NHS trusts focus on areas that will see the greatest benefit to their patients and ensure that they provide the care and support that people with osteoporosis need,” she added.

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