All Wales Audit of Secondary Prevention of Osteoporotic Fractures 2009
In December 2009, the All-Wales Osteoporosis Advisory Group (WOAG) published the report of the All-Wales Audit of Secondary Prevention of Osteoporotic Fractures. This highlights a national shortfall in services for people with osteoporosis and/or at risk of fractures in Wales. 17 NHS hospitals in Wales took part. The key findings are as follows:
Inpatient fracture care:
- seven hospitals (41%) have a funded service providing routine post-fracture assessment of future fracture risk for inpatients; only three of the 10 hospitals lacking an inpatient secondary prevention service do so because they do not admit fracture patients
- of the seven remaining hospitals that admit fracture patients but lack a funded inpatient secondary prevention service, five (71%) cite lack of funding as the reason
- two hospitals report that business plans have been submitted to establish a Fracture Liaison Service for the last three years without success.
Outpatient fracture care:
- four hospitals (24%) report having a funded service that provides routine post-fracture assessment of future fracture risk for outpatients
- of the 13 remaining hospitals that provide outpatient fracture clinics but lack a funded outpatient secondary prevention service, seven (54%) cite lack of funding as the reason for absence
- four hospitals report that repeated business plans have been submitted to establish a Fracture Liaison Service without success.
The audit results show that the NSF falls and fractures standard is not being implemented.
Other useful findings from the report
- only eight NHS hospitals (47%) have a dedicated ortho-geriatrician appointed at consultant level
- 13 NHS hospitals (76%) have local access to bone densitometry scanners
- seven NHS hospitals (41%) have an auditable database capable of monitoring implementation of national standards of care for secondary fracture prevention
- six NHS hospitals (35%) have an agreed protocol between their secondary fracture prevention service and local primary care.
WOAG is an independent body, comprised of healthcare professionals with an interest in osteoporosis across Wales. The National Osteoporosis Society is also represented on the group.