Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help prevent osteoporosis breaks; and what drugs are available from the NHS for people with that condition reduce the risk of repeat fractures.

In 2012, the National Institute for Health and Care Excellence published best practice clinical guidance on assessing the risk of fragility fracture. It aims to provide guidance on the selection and use of risk assessment tools in the care of adults at risk of fragility fractures in all National Health Service settings. The guidance recommends that clinicians consider assessment of fracture risk in all women aged 65 years and over and all men aged 75 years and over. Women aged less than 65 years and men aged less than 75 years should be considered for assessment in the presence of certain risk factors, such as a family history of hip fracture or low body mass index. The guidance can be found at the following link:

www.nice.org.uk/guidance/cg146

There are a number of therapies and treatments available for the prevention of fragility fractures in people who are assessed as being at risk, or to prevent further fractures in those who have already had one or more fragility fractures. Drugs available to help maintain bone density include: bone sparing agents, such as bisphosphonates; calcium and vitamin D supplements; and certain hormone based treatments.

Locally commissioned fracture liaison services (FLS) can also play a key role in reducing the risk of fracture in patients. These services systematically and proactively identify patients in secondary and/or primary care who have suffered a fragility fracture and assess the patient’s risk of future fragility fracture in a timely fashion. FLS then provide advice and/or therapy to reduce that risk. There is good evidence that these services are cost-effective and can result in a reduction in the incidence of fragility fractures in the local population. NHS England has developed a Falls and Fragility Fractures Pathway in partnership with Public Health England and the National Osteoporosis Society, as part of its Rightcare programme. Rightcare highlights the high value interventions that systems should focus on to address variation, improve outcomes, reduce cost and contribute toward a sustainable NHS. More information about the pathway can be found at the following link:

www.england.nhs.uk/rightcare/products/pathways/falls-and-fragility-fractures-pathway/