Debilitating hip fractures are causing more than 1,500 deaths a year in England because the NHS is failing to detect osteoporosis in patients, a charity has claimed.
Many patients with the bone-thinning disease also suffer from acute pain and mobility problems.
The Royal Osteoporosis Society (ROS) claims the deaths – mostly caused by heart problems caused by the hip injury – are preventable and are the result of a postcode lottery in NHS hospital trust screening services.
Fracture Liaison Services offers routine scans to anyone over the age of 50 who suffers a bone injury as a result of a minor accident – such as tripping and breaking a wrist – which can indicate low bone density and the risk of further fractures. If caught, they can be given medications to strengthen their bones, reducing the risk of future fractures.
But only half of England’s 123 hospital trusts have a fully functioning screening service, the charity claims. For example, patients lucky enough to live in Oxford or Bath will have routine bone checks if they are over 50 and suffer a fracture through a slip or fall.
Injuries such as hip fractures (pictured) can cause complications such as heart problems. The Royal Osteoporosis Society (ROS) claims the deaths are the result of a postcode lottery in NHS hospital trust bone screening services
Many patients with osteoporosis, a bone-thinning disease, also suffer from acute pain and mobility problems
But the latest figures for 2021 show no screening services are being offered in parts of north London, Manchester, Preston or Plymouth.
Linda Beirne, 62, from Lichfield, Staffordshire, fell foul of the system in 2019 when she broke her wrist in three places after slipping on a wet grass verge. Due to the lack of a good screening programme, Sandwell Hospital in Birmingham – where she lived at the time – never offered her a follow-up scan.
Still, relatives living elsewhere were monitored when they suffered similar injuries via a DEXA scan – a type of X-ray used to diagnose osteoporosis.
‘Every time I asked to be referred for a DEXA scan I was refused and told it wasn’t necessary,’ says Linda.
But seven months after her fall and thanks to repeated demands, Linda was eventually sent for a scan, which revealed she had moderate to severe osteoporosis.
“I felt completely abandoned,” Linda adds. ‘If I had not insisted on a scan, I would have been in real danger of breaking a hip.’
About half of those with a hip fracture have recently suffered a bone fracture.
Deborah Latter, 58, from East Sussex, was one of the lucky ones.
Within days of breaking her wrist while playing with her daughter, her local bone testing service contacted her. Scans showed she had early-stage osteoporosis in her spine and hips.
“I had no idea I had it,” says Deborah, who now takes alendronic acid to halt bone loss.
‘I thought it was something that only affects vulnerable old ladies. Everyone over 50 should have access to this service.”
Osteoporosis affects around 3.5 million people in Britain, and women are most at risk because levels of the hormone estrogen – which helps keep bones strong – drop after menopause.
Patients do not die directly from the disease; instead, it increases the risk of other fatal conditions, such as pneumonia or heart failure.
Craig Jones, chief executive of the ROS, estimates that 1,600 people die in England every year because their condition goes unnoticed.
“A third of patients with a hip fracture die within a year, often because they become bedridden and enter terminal decline,” he says.
The ROS is lobbying the government to release £27 million a year to help NHS trusts set up and run fracture screening services.
Health Secretary Maria Caulfield promised in August to “say more later this year” about how the Tories would expand the service. But ministers admitted this week that there are no plans, says Jones.
Dr. Nicola Peel, a consultant in metabolic bone medicine based in Sheffield, said the lack of funding was ‘very frustrating’, adding: ‘There is no doubt that people are suffering life-threatening hip fractures that could easily be prevented.’