I’ve lost count of the number of people – and it’s usually women – who come to my clinic after having suffered several painful fractures.
Some, in their 50s and otherwise in perfect health, have stumbled and injured a wrist or cracked a rib. For others it might be their third or fourth break in a matter of months, and they’re coming to me wondering why.
The stories are strikingly similar. They will have been to A&E multiple times over the years, or been suffering severe back pain.
And all of this will have had a devastating impact on their mood, relationships, their ability to live their lives normally and, crucially, their ability to work.
It’s heart-breaking to see, and as a GP I know that these issues are a red flag for a common but horrendous condition which causes bones to thin and weaken – osteoporosis.
When I refer them for a DEXA scan – a type of X-ray which measures the density of bone – lo and behold, they are finally diagnosed.
But in some parts of the country just getting that appointment can take up to two years.
For many of the 3.5 million people diagnosed with osteoporosis in the UK, it comes too late for treatment that can help protect against loss of bone density. Many end up suffering for years, in pain, becoming increasingly disabled and shuffling into an early grave.
For many of the 3.5 million people diagnosed with osteoporosis in the UK, it comes too late for treatment that can help protect against loss of bone density
On Thursday, when the Government published its Ten-Year Health Plan, there was no mention of osteoporosis (pictured: Wes Streeting)
But on Thursday, when the Government published its Ten-Year Health Plan, there was no mention of osteoporosis.
Other conditions, such as HIV, cancer and diabetes, got a mention. But not this one, which affects half of all women and one fifth of men.
That is why, this weekend, more than 100 of my colleagues – NHS doctors and hospital workers – have written to Health Secretary Wes Streeting urging him to finally make good on his pre-election commitment to prioritise early diagnosis for osteoporosis by rolling out Fracture Liaison Services (FLS) across England.
These screening clinics save lives by picking up the disease early, and prioritising people for safe, effective bone-sparing drugs. Right now, only half of England’s NHS Trusts have one, leading to an unacceptable postcode lottery across the country and putting people at risk.
As our letter reminds Mr Streeting, plugging those gaps where FLS is absent is crucial, because delay causes harm and costs lives.
The late diagnosis of osteoporosis leads to avoidable fractures, loss of independence, long-term disability and, in many cases, premature death.
In the past year alone, while Mr Streeting has sat on his hands, around 2,500 people have died due to preventable hip fractures alone. He has said the rollout will happen by 2030, but this delay could mean a further 12,500 deaths which FLS could have avoided. And there will have been 74,000 preventable fractures, including 31,000 life-threatening hip fractures, which will take up to 750,000 bed days. Those are beds the NHS sorely needs.
That is unacceptable, not to mention unimaginably tragic for those needlessly affected.
Many end up suffering for years, in pain, becoming increasingly disabled and shuffling into an early grave
So while Mr Streeting might say in the Ten-Year Plan he is committed to prevention, when it comes to osteoporosis that couldn’t be further from the truth.
It’s all the more baffling because rolling out FLS is an easy win. It would cost £30 million – 1.5 per cent of the £2 billion the NHS spends annually to treat hip fractures.
But studies show that a single FLS covers its cost after just 18 to 24 months – and after that saves the NHS money by reducing the number of hospital beds required for fracture patients.
And Mr Streeting knows all this. When he was in Opposition, he talked about it endlessly. After the Conservative government said it would roll out FLS, he criticised it for being too slow.
Then, in May 2024, he promised that should Labour win the upcoming General Election, it would fully fund them.
The following month, taking a more personal tone, he went further, telling this newspaper that it would be one of his first acts in Government because a close relative had broken a hip after becoming a victim of the postcode lottery for bone-density scans.
But after Labour won the Election in July, it went quiet. To add insult to injury – quite literally – he was caught on video in January mocking charities for campaigning to improve the lives of patients, sarcastically singling out the Royal Osteoporosis Society as the ‘worst offender’ when it came to ‘lobbying’ the Government.
Only in February did he finally say the FLS plan would be implemented ‘by 2030’, but it came with no indication as to how this would be achieved.
Today, even after the Ten-Year Plan has been punished, that remains the case.
As our letter reminds Mr Streeting, plugging those gaps where FLS is absent is crucial, because delay causes harm and costs lives
This ongoing failure to drive this forward is a huge blow for those yet to be diagnosed with osteoporosis – they can get access to safe, effective medication only if they’re diagnosed.
I know this, unfortunately, from my own personal experience with this disease.
In early 2023 I asked my GP for a DEXA scan after a friend fractured a wrist and hip playing tennis. I was found to have the bones of a 90-year-old, despite then being 60 (I’m now 62), and was diagnosed with the disease.
And I know I was lucky. I got the right treatment to improve my bone density – and I’ve still never had a fracture.
Without that early knowledge, I’d have likely suffered multiple breaks by now.
Every day, every week, every month this Government delays rolling out FLS, more people suffer preventable injuries – an own goal, because it then costs them more to treat them.
If you have a hip fracture, you’re up to eight times more likely to die within three months, and three to four times more likely to die within a year. Three quarters of those who fracture a hip never have the same level of independence.
The human misery this causes is horrendous.
Yet FLS would save the NHS £440 million over five years and free up 36,000 hospital beds every winter. Quite simply, this isn’t something that can wait.
There is the political will, Mr Streeting, but we now need an urgent way forward.
