Preventing the next fracture

Spotting osteoporosis and bridging the gap in NHS care

Every year in the UK, over 500,000 patients aged 50 and over break a bone after a fall. Breaking a bone increases the chances of another broken bone that could take away a patient’s ability to wash and dress themselves, walk safely or even live in their own home. As a result of the ageing population, secondary fracture prevention is a priority for health services at both the local and national levels. Ten years ago, the NHS recommended that medications to strengthen a person’s bone should be routinely available. Sadly, most patients who break a bone after a fall today will not receive the recommended tests and treatments and will continue to break bones leading to more time in hospital and a reduced quality of life. Key barriers in not receiving the correct treatment include poor coordination of care between hospital and GPs as well as the lack of awareness of the dangers of worsening bone health by patients, their families and professionals. Providing effective secondary fracture prevention to all eligible patients would prevent almost 54,000 fractures within the first 5 years of implementation.

What is the NHS doing to close this care gap?

The NHS is now recommending that specialist teams called Fracture Liaison Services (FLSs), find, test and recommend treatments for adults who break a bone.


Recognising the importance of national data, the NHS has also set up a mandatory national audit to help improve how well FLSs work. The Fracture Liaison Service Database (FLS-DB) measures the FLSs work against nationally set standards for secondary fracture prevention. The results of this audit can be seen in many ways:

  1. Live on the FLS-DB website
  2. Annual report from the FLS-DB
  3. Patient leaflet and animation

The FLS-DB team have found that not every patient is covered by an FLS and not every FLS is working as well as it should, in order to keep patients safe.