- Posted by: Joyce Watson MS
- Category: Feature
Some improvements but Welsh patients still face postcode lottery
An audit of fracture services in Welsh hospitals has reported that thousands of hip fractures could have been prevented with earlier intervention.
Assembly Member Joyce Watson launched the findings at a reception at the National Assembly for Wales on Wednesday (5 December). The Mid and West Wales AM has campaigned with the National Osteoporosis Society for several years, championing Fracture Liaison Services (FLS).
Speaking at the event in Cardiff, Mrs Watson said: “Osteoporosis is common and getting more common. About 3 million people in the UK have it, and with our aging population that number is likely to go up.”
“When someone has weak bones, a seemingly innocuous fall can be life changing, or even life ending. Falls are the most common cause of death due to injury in people aged over 75 in the UK. That is why Fracture Liaison Services, like the ones run at Bronglais, are vital for getting an early diagnosis and better treatment.”
Bronglais Hospital was the first in Wales to have a fracture liaison service. In July, specialist osteoporosis nurse, Debbie Stone was awarded the MBE in recognition of her work with osteoporosis patients at the west Wales hospital.
17 hospitals across Wales participated in the All Wales Audit of Secondary Prevention of Osteoporotic Fractures 2012, which investigated the provision of Fracture Liaison Services (FLS) across Wales. It reviews the findings of a 2009 audit by the All Wales Osteoporosis Advisory Group and estimates that more than 2,400 patients, who will break their hip in the future, could have received preventative intervention but did not because almost half of Welsh hospitals lack a FLS.
Successful FLSs assess people over the age of 50 who have broken a bone to determine their risk of further fractures, and if appropriate, they are referred for a diagnostic scan and prescribed treatment. This simple and straight-forward process has been proven to prevent further fractures and could save money for the NHS in Wales.
During September 2012, the All Wales Osteoporosis Advisory Group (WOAG) undertook an audit of all acute centres in Wales that manage fragility fracture patients. The issue of fracture risk reduction is a key part of the National Service Framework (NSF) for Older People in Wales.
Although the review identifies some improvements since the 2009 audit, it highlights the gaps in care and funding that are still preventing many patients from receiving assessments that could save lives and money.
Key findings include the following:
- Nine hospitals have a funded service that routinely assesses future fracture risk for inpatients, compared to seven in 2009
- Seven hospitals now have a funded service that routinely assesses future fracture risk for outpatients, compared to four in 2009.
- Since 2009, two more hospitals are now funded (9 out of 14) to assess fracture inpatients for their risk of further fracture, compared to 7 in 2009.
- Of the hospitals without any Fracture Liaison Service, most cite lack of funding as the reason for absence.
- Of the 14 hospitals that admit fracture patients, 10 (71%) have a dedicated ortho-geriatrician appointed at consultant level, an increase from 8 hospitals (57%) in 2009.
The original 2009 report also identified financial savings for Wales if access to Fracture Liaison Services were provided for all inpatients and outpatients following a fracture. The Group found that the cost of providing services is £2.81 million over a five year period, saving £2.98 million over that same five year period.
Dr Mike Stone, Chair of the All Wales Osteoporosis Advisory Group said: “We know that almost half of hip fracture sufferers experience a prior fragility fracture before breaking their hip, which provides a clear opportunity for secondary fracture prevention. So why are around half of Welsh hospitals allowing patients presenting with fragility fractures today to needlessly remain at high risk of suffering further fractures in the future?
“We demand an immediate inquiry from the Minister for Health and Social Services, the Commissioner for Older People in Wales and the leadership of Local Health Boards. We also call upon Assembly Members to ask the leadership of Local Health Boards within their constituencies whether funded Fracture Liaison Services are in place for the local population, and if not, why not?”
Osteoporosis causes fragile bones, which can lead to agonising and disabling fractures. 1,150 people die every month in the UK as a result of hip fractures.
The All Wales Audit of Secondary Prevention of Osteoporotic Fractures 2012 report was published today during a round table meeting that was attended by AMs, health professionals, patients and representatives from the National Osteoporosis Society.