In the UK, the focus of osteoporosis care in the NHS has been on people who have sustained a fragility fracture as a result of their underlying condition. Not much has been done to try and prevent the first fracture by promoting good bone health and proactively identifying people at higher risk.
This report by the APPG on Osteoporosis and Bone Health presents the results of its inquiry into primary care provision for people with osteoporosis and those at high risk of fracture, launched in March 2022. The inquiry aimed to establish the current quality of care being offered to patients.
- The National Screening Committee should reconsider the case for a targeted national screening programme to detect high fracture risk in 2023.
- The Government should instigate a public health campaign to address the lack of awareness and complacency in the public about bone health.
- Osteoporosis must be given parity with other long-term conditions, and defined as such within the NHS, to allow enhanced and equitable care and management.
- NHS England must outline plans to expand DXA services to deliver and exceed their recommended 4% increase in capacity in order to tackle the current backlog and future-proof services, and improve access by including DXA in minimum specifications for Community Diagnostic Centres.
- Every individual who requires ongoing management or surveillance to reduce their fracture risk should have a personalised ‘bone health management plan’ with a specified timescale for reviews.
- ICSs should utilise the breadth of skills and expertise within the multi-disciplinary team to optimise and streamline local management pathways for people at high risk of fragility fracture.
- Establish a new National Specialty Adviser for Fracture prevention and Osteoporosis within the NHS England and NHS Improvement clinical advisory structure, and equivalent in Scotland, Wales and Northern Ireland.
- The APPG recommends proportionate recognition of the importance of osteoporosis throughout healthcare education, with increased prominence in undergraduate and post-graduate healthcare professional training.
- Specialist services must support primary care colleagues to provide the best care to patients.
- All relevant national guidelines should be reviewed to better support imaging of the spine where there is a suspicion of vertebral fracture, particularly in patients with risk factors for osteoporosis.
- NHS England must provide sufficient funding for ICSs to deliver against national quality standards and NICE clinical guidance.
APPG on Osteoporosis and Bone Health inquiry report: Fracture prevention and osteoporosis in primary care (16 November 2022) https://strwebprdmedia.blob.core.windows.net/media/vxuhotlh/appg-on-osteoporosis-and-bone-health-inquiry-report-into-primary-care-2022.pdf
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