This statement updates Members about the achievement of our target to set up fracture liaison services across Wales by the deadline of September 2024.
Fracture liaison services ensure people aged 50 and over who experience a broken bone after a fall have their bone health and falls risk checked and managed to reduce the risk of a subsequent fracture. The service features a team of healthcare professionals and services have been shown to benefit individuals and be a both clinically and cost-effective form of early intervention, which helps avoid future hospital admission.
It is due to the dedication of Dr Inder Singh, the National Clinical Lead for Falls and Frailty and his team, in collaboration with the Six Goals for Urgent and Emergency Care programme and the Welsh Value in Health Centre that more than £1m has been invested to develop fracture liaison services in areas in areas where no service previously existed, and to support expansion and improvement of existing services.
Fracture liaison services have been established in the six university health boards and mutual agreements are in place between Powys teaching Health Board and adjacent district general hospitals to ensure access to services for people living in Powys communities. The funding has enabled the recruitment of 13 clinical nurse specialists and 11 administration staff.
While we can celebrate rolling out fracture liaison services across Wales, the journey does not end here. Each health board has made a long-term commitment to continue to develop and improve their service to support the needs of their local population and to reduce the impact falls and fractures have on individuals and on the NHS.
Our priority in the next phase of this work will be to nurture the ongoing development of services and continuing to work with Powys teaching Health Board to strengthen its fracture liaison service provision by considering what can be delivered in the community.
Timely access to Dual-Energy X-ray Absorptiometry (DXA) services is essential for the effective management of people with osteoporosis and those at high risk of fractures and is key to the continued success of the fracture liaison service model in Wales. DXA is a medical imaging technique used to measure bone mineral density; it is considered the gold standard for diagnosing osteoporosis and assessing fracture risk. The results from a DXA scan help clinicians evaluate bone health, monitor changes over time, and guide treatment decisions.
DXA services in Wales are facing a number of challenges in relation to capacity, quality and workforce. Dr Singh and the Fracture Liaison Service Quality Assurance and Development Group will work with health boards over the coming 12 months to address the backlog in DXA services; improve access to scans and reporting, and invest in workforce training and development.
As part of our wider commitment to improving and raising awareness of bone health, we are also working with clinical networks and bone health colleagues, third sector partners and people with lived experience across Wales to co-produce the Quality Statement for Osteoporosis and Bone Health, which will set out our expectations for better bone health services across Wales.
Following its publication, NHS Wales will be supported to deliver bone health improvements by the musculoskeletal strategic clinical network, and in collaboration with the Six Goals for Urgent and Emergency Care programme and clinical networks for orthopaedics, rheumatology and persistent pain.
