In December, Wales went further – pledging to meet the world’s highest standards for FLS care by 2030. This means ensuring every patient over 50 is assessed, treated and supported to stay on their medication.
Dr Inder Singh, Wales’ National Clinical Lead for Bone Health, said: “The impact of fragility fractures is significant and unmeasurable. Therefore, preventing secondary fractures is our key goal in Wales and it has been comprehensively backed by the Welsh Government.”On the other side of the world, New Zealand is also outpacing England. Inspired by the original UK model, they launched their first FLS in 2014 – and now have 99% of the population covered, with full access expected by mid-2025.
This is down to years of collaboration between government, health bodies and campaigners like Osteoporosis New Zealand, with funding from the country’s national injury prevention agency.
Christine Gill, Clinical Programme Director at Osteoporosis New Zealand. “Inspired by early UK innovations in FLS, we now hope our experience can, in turn, offer some encouragement to our colleagues in England as they seek to extend FLS access nationwide.”
Japan – where 30% of the population is over 65 – has also surged ahead, according to the ROS. A major government policy shift in 2022 introduced new payments to incentivise hospitals to treat fragility fractures and set up FLS.
Since then, the number of services has more than doubled – from 47 to 120 – with every prefecture now covered. Japan now holds 22 international “gold stars” for best practice in fracture prevention. England has just 7.
Professor Atsushi Suzuki of Fujita Health University said: ““A bold central government initiative in Japan recognised the importance of Fracture Liaison Services to managing the health needs of an ageing population.
He added: “The approach that made Japan a world leader in beating osteoporosis could be an inspiration to ministers in the UK.”
In May 2024, Health Secretary Wes Streeting pledged to make FLS universal in England by 2030 – a promise backed by all major political parties. But a year later, no action has been taken to turn that pledge into reality.
Speaking at the Labour Party Conference last autumn, Mr Streeting admitted campaigners had made a “really good, evidenced example of what prevention looks like” – adding: “Now we will keep the promise.”
The ROS estimates:
500,000 broken bones a year caused by osteoporosis
90,000 people miss out on treatment due to poor coverage
Osteoporosis is the 4th leading cause of disability and premature death in the UK
The disease costs £4.5 billion a year to the economy and NHS
1 in 2 women and 1 in 5 men over 50 will suffer an osteoporosis-related break
Campaigners are now urging ministers to follow through on their promises – and ensure no more patients are left behind. They want England to match the quality, coverage and ambition already achieved in Wales, Japan and New Zealand.
A spokeswoman for the Department of Health and Social Care said: “We inherited a broken NHS, leaving patients – including those with osteoporosis – waiting far too long for treatment. We’re fixing it and we remain committed to rolling out FLS across every part of the country by 2030.
“In the meantime, we’re rolling out high-tech DEXA scanners to deliver 29,000 scans a year for faster diagnosis. Our Plan for Change is slashing wait times from 18 months to 18 weeks – and we’ve already delivered more than 3.5 million additional appointments, getting patients the care they need in a quicker time.”