The provision of fracture liaison services (FLS) is a matter for local clinical commissioning groups.

Whilst programme budgeting data provides figures for annual National Health Service spend on musculoskeletal services in England, the cost of treating individual musculoskeletal conditions, such as osteoporosis, or specific services such as linking a FLS to every hospital in England, is not available as part of this data.

The provision of fracture liaison services (FLS) is a matter for local clinical commissioning groups (CCGs). Information concerning the number of hospitals in England which presently have a linked FLS is not collected centrally.

NHS England supports the FLS model recommended by the International Osteoporosis Foundation and the National Osteoporosis society and recognises this model as best practice. NHS England is working with CCGs to support them to develop appropriate local services and services are steadily improving.

The provision of fracture liaison services (FLS) and falls services is a matter for local clinical commissioning groups (CCGs) and data on numbers is not collected centrally. NHS England advises that it is aware that provision of good FLS is not uniform across the country and is working with CCGs to support them to develop appropriate local services. It also advises that the FLS model recommended by the International Osteoporosis Foundation and the National Osteoporosis society is recognised as best practice and is being promoted. In addition to this, the guidance from the National Institute for Health and Care Excellence (NICE) ‘Falls: assessment and prevention of falls in older people’ sets out best practice for clinicians on the management of patients aged 65 and over who are susceptible to falls.

Regarding the cost to the National Health Service of treating fractures attributable to osteoporosis, whilst programme budgeting data provides figures for annual NHS spend on musculoskeletal services in England, the cost of treating individual musculoskeletal conditions, such as osteoporosis or specific services such as FLS, is not available as part of this.

Information concerning the number of people affected by osteoporosis in each of the last five years is not collected. NICE estimates that over 300,000 patients present with fragility fractures to hospitals in the United Kingdom each year.

The provision of fracture liaison services (FLS) and falls services is a matter for local clinical commissioning groups (CCGs) and data on numbers is not collected centrally. NHS England advises that it is aware that provision of good FLS is not uniform across the country and is working with CCGs to support them to develop appropriate local services. It also advises that the FLS model recommended by the International Osteoporosis Foundation and the National Osteoporosis society is recognised as best practice and is being promoted. In addition to this, the guidance from the National Institute for Health and Care Excellence (NICE) ‘Falls: assessment and prevention of falls in older people’ sets out best practice for clinicians on the management of patients aged 65 and over who are susceptible to falls.

Regarding the cost to the National Health Service of treating fractures attributable to osteoporosis, whilst programme budgeting data provides figures for annual NHS spend on musculoskeletal services in England, the cost of treating individual musculoskeletal conditions, such as osteoporosis or specific services such as FLS, is not available as part of this.

Information concerning the number of people affected by osteoporosis in each of the last five years is not collected. NICE estimates that over 300,000 patients present with fragility fractures to hospitals in the United Kingdom each year.

The Department does not hold this information. Responsibility for determining the overall national approach to improving clinical outcomes from healthcare services, including fracture liaison services, lies with NHS England.

Information concerning the number of people affected by osteoporosis in each of the last five years is not collected.

Regarding the cost to the national health service of treating fractures attributable to osteoporosis, while programme budgeting data provides figures for annual NHS spend on musculoskeletal services in England, cost of treating individual musculoskeletal conditions, such as osteoporosis, is not available as part of this.

Finally, the following table provides a count of finished admission episodes (FAEs) with a primary or secondary diagnosis of fractures attributable to osteoporosis in women and men in the age categories requested for the last five years. The table also provides data of FAEs where the gender of the patient was not recorded.

The Department's Mandate to NHS England sets an objective for NHS England to make measurable improvement in helping people to recover from episodes of ill health or following injury. Alongside this, the NHS Outcomes Framework includes a specific indicator whereby the national health service has been set an objective to improve patient recovery from fragility fractures by measuring the proportion of patients recovering

to their previous levels of mobility/walking ability at 30 and 120 days following injury. In addition to this indicator, the Clinical Commissioning Group Outcome Indicator Set also has a specific indicator, measured at clinical commissioning group (CCG) level, to improve recovery from fragility fractures including hip fracture, through a formal hip fracture programme, timely surgery, and multifactorial risk assessment.

The responsibility for determining the overall national approach to improving clinical outcomes from health care services, including fracture liaison services (FLS), now lies with NHS England. FLS aim to reduce risks of further falls and fragility fractures in older patients. This preventative approach is beneficial to patients, reduces future hospital admissions and is cost effective for the NHS. NHS England supports the FLS model recommended by the International Osteoporosis Foundation and the National Osteoporosis society and recognises this model as best practice. However, NHS England advises that it is aware that provision of good FLS is not uniform across the country. NHS England is working with CCGs to support them to develop appropriate local services and services are steadily improving.

NHS England also supports the "Falls and Fragility Fracture Audit Programme" commissioned by the Healthcare Quality Improvement Partnership (HQIP) and delivered by the Royal College of Physicians. The audit supports the providers of services to improve outcomes and efficiency of care after hip fracture, helps to improve services in acute and primary care to respond to first fracture, and prevent second fracture through early intervention to restore independence.

The latest report from the “National Hip Fracture Database” shows that care for hip fracture patients is improving with more patients receiving surgery within 48 hours of admission than in 2012, and almost all patients (94%) receive a falls assessment before being discharged from hospital. This report shows an improvement in the care for frail, older patients with broken hips.

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 advises that it is aware that provision of good FLS is not uniform across the country and is working with clinical commissioning groups to support them to develop appropriate local services. It also advises that the FLS model recommended by the International Osteoporosis Foundation and the National Osteoporosis society is recognised as best practice and is being promoted.

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 advises that it is aware that provision of good FLS is not uniform across the country and is working with clinical commissioning groups to support them to develop appropriate local services. It also advises that the FLS model recommended by the International Osteoporosis Foundation and the National Osteoporosis society is recognised as best practice and is being promoted.

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 has advised that the FLS 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 appropriate National Clinical Director at NHS England, working with the National Osteoporosis Society, to consider how to further promote best practice and treatment.