Supporting an extra 1000 patients living with Osteoporosis to avoid future fractures
NHS Trust’s across the Thames Valley region have saved £1.5m and avoided nearly 2,000 bed days by introducing nurse-led Fracture Liaison Services on-site in locations including Reading, Oxford, and Buckinghamshire, with Frimley to follow suit in the coming months.
This consistent model of support means that in just over a year an additional 1,000 patients recovering from fractures have been identified, acknowledged as ‘at risk’ for future fractures based on the outcome of proactive tests, and received treatment including long-term support to reduce that risk. Alongside the financial savings and reduction of bed days needed, the Royal Osteoporosis Society also worked out that in the single 12-month period they looked at, 200 potential future fractures have also been avoided.
This work has been driven by the Acute Provider Collaborative which was set up in 2023 and brings together Buckinghamshire Healthcare NHS Trust, Oxford University Hospitals NHS Foundation Trust, Royal Berkshire NHS Foundation Trust, and Frimley Health NHS Foundation Trust to identify where things can be ‘done once’ – improving patient care and experience. Since its set up it has explored good practice happening in particular Trusts and supported and enabled ways of working to be rolled out across the entire patch.
(Caption: Fracture Liaison Service staff from Berkshire, Buckinghamshire, Oxford, and Frimley.)
Bobby Ancil, Head of Health Services Development at the Royal Osteoporosis Society said, “This investment in Fracture Liaison Services should be recognised and sustained as a model of excellent practice. Fracture Liaison Services are the gold standard for secondary fracture prevention, and evidence shows that well-resourced services reduce re fracture risk by up to 40% while improving patient outcomes and driving long term system savings. Ongoing support and development of these services will be vital to improving bone health outcomes across the region.”
Professor Kassim Javaid, Honorary Adult Rheumatology Consultant, Oxford University Hospitals Foundation Trust, and Clinical Lead for the project said, “A major value of this innovative ICS-wide service is the rapid sharing of knowledge, skills and expertise it allows. By leveraging existing expertise within the ICS, we have ensured both consistent care delivery for all patients as well as fast tracking new Fracture Liaison Services to get set up and become effective rapidly. It has been inspiring seeing the nurse leadership develop and drive the Fracture Liaison Service delivery so no adult with a recent fracture is left behind.”
A simple trip or fall can lead to a fracture, especially in someone over the age of 50 – often ending up in a visit to a local Emergency Department or to the GP. Nurses within the Fracture Liaison Service now in place across these Trusts proactively look for people who have had a fracture and reach out to them to assess their osteoporosis risk. This can involve having DEXA scan to confirm or rule out a diagnosis, and if confirmed organising the treatment and support needed, and following-up over a 12 month period to make sure any support needed is in place.
Steve McManus, Chief Executive Officer of the Royal Berkshire NHS Foundation Trust and Acute Provider Collaborative said, “We know that for people with osteoporosis that intervening early can make s huge difference to their outcomes, especially in the longer term.
“The nurse-led service now in place in Berkshire, Buckinghamshire, and Oxford means we can spot people with the condition earlier, and get them the treatment and support they need – reducing the risk of it escalating into a more serious presentation – for example a hip fracture, with all the implications that can come with that. Often, by small changes to lifestyle – for example by simply walking more, or taking medication we can slow the progress of any osteoporosis and allow people to carry on with life as normal.”