This information is not available in the format requested. In the following tables we have provided a count of finished admission episodes (FAEs) with a primary or secondary diagnosis of fractures attributable to osteoporosis by men and women aged 50 or above, for the years 2003-04 to 2012-13.

We have also provided a count of FAEs for men and women aged 50 and over with a primary or secondary diagnosis of fracture of a hip, wrist, vertebra, femur, neck and knee for the years 2003-04 to 2012-13. We have also included FAEs for men and women aged 50 and over with a primary or secondary diagnosis of fracture of the lower arm. This is because coding advice for wrist fracture is difficult to interpret. There are several bones in the wrist itself, and there are the ulna and radius bones which extend from the wrist to the elbow. Common understanding of wrist fracture would include fractures to the ulna or radius close to the wrist, but we cannot identify where on the bone the fracture occurred, only the bone itself.

This data is limited to admitted patient care, some of these types of fracture are likely to be dealt with in accident and emergency or another healthcare setting.

FAEs are not a count of patients because a patient may have had more than one episode of care within the time period.

FAEs with a primary or secondary diagnosis of fractures attributable to osteoporosis by men and women aged 50 or above, for the years 2003-04 to 2012-13.

This information is not available in the format requested. In the following tables we have provided a count of finished admission episodes (FAEs) with a primary or secondary diagnosis of fractures attributable to osteoporosis by men and women aged 50 or above, for the years 2003-04 to 2012-13.

We have also provided a count of FAEs for men and women aged 50 and over with a primary or secondary diagnosis of fracture of a hip, wrist, vertebra, femur, neck and knee for the years 2003-04 to 2012-13. We have also included FAEs for men and women aged 50 and over with a primary or secondary diagnosis of fracture of the lower arm. This is because coding advice for wrist fracture is difficult to interpret. There are several bones in the wrist itself, and there are the ulna and radius bones which extend from the wrist to the elbow. Common understanding of wrist fracture would include fractures to the ulna or radius close to the wrist, but we cannot identify where on the bone the fracture occurred, only the bone itself.

This data is limited to admitted patient care, some of these types of fracture are likely to be dealt with in accident and emergency or another healthcare setting.

FAEs are not a count of patients because a patient may have had more than one episode of care within the time period.

FAEs with a primary or secondary diagnosis of fractures attributable to osteoporosis by men and women aged 50 or above, for the years 2003-04 to 2012-13.

Information on the cost to the public purse of repairing broken hips in the elderly is not reported separately to the Department.

Data on the number of people aged 65 and over who suffered a hip fracture following a fall in each of the last 10 years is in the following tables.

The safety of young people in custody is our highest priority. The behaviour of some young people is sometimes extremely challenging and can put the safety of other young people and staff at serious risk. The management of this behaviour is crucial to creating a safe environment for young people and staff.

The Government is clear that restraint should only ever be used against young people as a last resort where it is absolutely necessary to do so and where no other form of intervention is possible or appropriate.

All establishments holding young people have Restraint Minimisation Strategies in place to promote an establishment-wide commitment to minimising incidents of restraint.

Since 2008 there have been four uses of force incidents in HMYOI Hindley that have resulted in bone breaks or fractures. There was one in 2009, two in 2010, and one in 2011. In two of the incidents force was used to gain compliance from the young person to ensure their safety and that of the staff involved. In the other

two incidents force was used to prevent harm to others. In all cases the young person was seen by a local authority social worker, a child protection case was opened, and a local strategy meeting held to ensure correct procedures were followed. Only one of the young people requested support during his post-restraint debrief by an independent advocate. No reports were published by the persons above mentioned.

In 2011 a young person was restrained and treated for a suspected fractured wrist, however after a number of fact finding investigations involving internal and external healthcare providers it was concluded that the young person had not received a fractured wrist during the restraint.

Responsibility for determining the overall national approach to improving clinical outcomes from healthcare services, including fracture liaison services (FLS), lies with NHS England.

NHS England is aware that the provision of FLS is not uniform across the country and is working with clinical commissioning groups to support them to develop appropriate local services. It will be for the

National Clinical Director for Major Trauma, Chris Moran, working with the National Osteoporosis Society, to consider how to further promote best practice and treatment.

Responsibility for determining the overall national approach to improving clinical outcomes from healthcare services, including fracture liaison services (FLS), lies with NHS England.

We understand from NHS England that the model recommended by the International Osteoporosis Foundation and the National Osteoporosis society has been assessed as being best practice and is being promoted.

NHS England is aware that the provision of good FLS is not uniform across the United Kingdom and is working with clinical commissioning groups to support them to develop appropriate local services. It will be for the National Clinical Director for Major Trauma, Chris Moran, working with the National Osteoporosis Society, to consider how to further promote best practice and treatment.

Responsibility for determining the overall national approach to improving clinical outcomes from healthcare services, including fracture liaison services (FLS), lies with NHS England.

We understand from NHS England that the model recommended by the International Osteoporosis Foundation and the National Osteoporosis society has been assessed as being best practice and is being promoted.

NHS England is aware that the provision of good FLS is not uniform across the United Kingdom and is working with clinical commissioning groups to support them to develop appropriate local services. It will be for the National Clinical Director for Major Trauma, Chris Moran, working with the National Osteoporosis Society, to consider how to further promote best practice and treatment.

The Department does not hold this data, as the information collected on nurses via the non-medical workforce census does not separately identify those who would be working in this area. Fracture liaison nurses are not a recognised job title.

Local healthcare organisations, with their knowledge of the patients they serve, are best placed to plan and employ a workforce appropriate to the needs of their patients, based on clinical need and sound evidence. Where changes are planned to the size and shape of the workforce, healthcare organisations must provide assurance that the safety and quality of patient care is maintained or improved. The process should include clinical involvement, leadership and sign off.

Commissioners of services will want to know that their workforce is fit to support the quality of care they want for patients and we are expecting Boards who provide services to publish their staffing numbers for the first time this year.

The NHS Mandate makes it clear that quality of care is as important as quality of treatment. Nursing leaders must ensure that their teams are focused on delivering person-centred, intelligent and compassionate care where the patient's fundamental requirements for daily living have the priority they deserve.

The information on fracture liaison services linked to every hospital is not held centrally by the Department or NHS England. Local commissioners are primarily responsible for determining what steps are needed to improve the health and care of people with fragility fractures.

The Royal Society for the Prevention of Accidents published on 13 June 2013 an on-line handbook ‘Delivering Accident Prevention at a local level in the new public health’ system funded by the Department and supported by Public health England.

It aims to assist local authorities and local commissioners with information to improve injury prevention including strategies and services to reduce falls and the risk of accidental injury.

No targets have been set for outcomes from this injury but the Government has taken steps to support improvement and will be passing responsibility for current arrangements through to the NHS Commissioning Board in April.

The Department commissioned the National Institute for Health and Clinical Excellence (NICE) to publish a Quality Standard which describes what clinicians have agreed is good practice. The Department has also encouraged clinical participation in the National Hip Fracture Database (NHFD), which forms part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) managed by the Healthcare Quality Improvement Partnership. Participation in NCAPOP audits is a condition of the NHS standard contract.

The NHFD collects data on the incidence of and therapeutic interventions provided in response to these injuries. This data from the NHFD is used to support the payment of a best practice tariff that gives a premium payment by result to national health service providers who treat patients in a manner consistent with the NICE Quality Standard.