Fracture Liaison Service provision

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Dear Harrogate and District NHS Foundation Trust,

The Royal Osteoporosis Society is undertaking a Freedom of Information Act (FOI) request of all Trusts, Health Boards and Health and Social Care Trusts, with the aim of assessing the number of Fracture Liaison Services (FLS) that exist across the UK and the delivery of these services.

Fracture Liaison Services (FLS) systematically identify people aged 50 and older who have had a 'fragility fracture', with the aim of reducing their risk of further fractures.

The All-Party Parliamentary Group (APPG) on Osteoporosis and Bone Health have agreed to conduct an Inquiry into access to Fracture Liaison Services (FLS) across England. To support the early work of the group, Parliamentarians have asked for a Freedom of Information (FOI) request to be circulated to all commissioners and service providers in England to better understand current FLS provision and levels of variation across the country.

Data will be used to identify how we can target future resources to ensure that all patients at risk of secondary fragility fractures and osteoporosis have access to and are referred to a FLS for further bone health assessment.

We really appreciate your help with this, especially as we understand the pressures that healthcare services are currently experiencing. Please pass the questions below on to your Fracture Liaison Service or if this is not possible, please pass on to your osteoporosis clinical lead or musculo-skeletal lead for them to complete.

We ask that you please indicate your answer by marking with an “X” next to any answers that apply or by deleting all answers that do not apply. Please avoid answering by italics, underlining or bold, as these do not show up when we process your response.
Yours faithfully,

Craig Jones, Chief Executive, Royal Osteoporosis Society

1. Do your patients over 50 years old have access to a Fracture Liaison Service (FLS)?
a. Yes
b. No commissioned FLS but pathway for bone health management of fracture patients
c. No commissioned FLS and no pathway for bone health management of fracture patients

If you answered ‘no’ (b or c) please move on to question 15.

2. Is your FLS based in secondary care?
a. Yes
b. No

3. For 2019, what percentage of people over 50 with a fracture were offered access to a FLS?
a. (please specify:)

4. For 2019, what percentage of people referred to FLS received an assessment within 12 weeks of fracture diagnosis?
a. (please specify:)

5. For 2019, for those patients receiving osteoporosis drug treatment what percentage were reviewed for follow up 16 weeks from fracture?
a. (please specify:)

6. For 2019, For those patients receiving osteoporosis drug treatment what percentage were reviewed for follow up 52 weeks from fracture?
a. (please specify:)

7. For 2020, what percentage of people over 50 with a fracture were offered access to a FLS?
a. (please specify:)

8. For 2020, what percentage of people referred to FLS received an assessment within 12 weeks of fracture diagnosis?
a. (please specify:)

9. For 2020, for those patients receiving osteoporosis drug treatment what percentage were reviewed for follow up 16 weeks from fracture?
a. (please specify:)

10. For 2020, For those patients receiving osteoporosis drug treatment what percentage were reviewed for follow up 52 weeks from fracture?
a. (please specify:)

11. Is this a permanent service funded by a sustainable source? (e.g., commissioning, health board/trust funded)
a. Yes
b. No
c. partially (please specify:)

12. Do you take part in a national FLS audit? (e.g. FLS-DB)
a. Yes
b. No

13. Please state the name and contact details of the Clinical Lead for this service
a. (please specify)

14. Are there any areas of support you would like further information/support from the ROS? E.g., Clinical Standards, KPIs, Service Improvement / Patient Information etc
a. (please specify:)

For those that answered ‘no’ to having an FLS (question 1).

15. What are the reasons you do not have an FLS, or access to an FLS for your patients?
a. (please specify:)

16. Have you tried to establish a FLS previously?
a. Yes
b. No
c. We are in the process of developing a FLS

17. What has been the barrier/obstacles to implementing a FLS?
a. (Please specify:)

18. If you have not tried to establish a FLS previously, why not?
a. (Please specify)

19. Do you have an osteoporosis service?
a. Yes
b. No

20. Do you have a DXA (bone density scanning) service?
a. Yes
b. No

21. Please state the name and contact details of the Clinical Leads for osteoporosis, rheumatology or musculo-skeletal, services
a. (please specify)

22. Are there any areas of support around FLS that you would like further information/support on from the ROS? E.g. patient info, Clinical Standards, KPIs, Service Improvement / Patient Information etc
a) (please specify)

FREEDOMOFENQUIRIES (HARROGATE AND DISTRICT NHS FOUNDATION TRUST),

Freedom of Information requests during the current Coronavirus (COVID-19)
pandemic

Harrogate and District NHS Foundation Trust are committed to complying
with the Freedom of Information Act (FOI) 2000.  During this extraordinary
period we would like to ask you for your patience and understanding when
submitting a FOI request.  At the current time, we are having to
prioritise other areas and adapt our usual approach to these requests.  We
will continue to process these within the 20 working day timescale given
under the FOIA whenever we can, but this will be dependent on the
availability of staff, which could impact on timely delivery of FOI
responses during this challenging period. 

 

We would like to apologise for any inconvenience that this may cause, and
assure you that we will get the requested information to you as soon as
possible. Can we please ask that you consider if your request is still
required or can be delayed until after this pandemic is over.

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Dear Harrogate and District NHS Foundation Trust,

Please can we have your response to the FOI request that was submitted on the 18th May 2021 and is now passed the 20 working days deadline?

Yours faithfully,

Steven

LEECH, Stacy (HARROGATE AND DISTRICT NHS FOUNDATION TRUST),

1 Attachment

 

[1]hdft-logo-trimmed-white

Response sent by email to: Freedom of
Information Officer
[email address]
Strayside Wing
 Steven
<[FOI #756154 email]> Harrogate District
Hospital

Lancaster Park Road

Harrogate HG2 7SX

 

Direct Dial:
(01423) 554423

Email: 
[2][email address]

Freedom of Information Request – FOI1386

2 August 2021

Dear Sir/Madam

 

Thank you for your request received under the Freedom of Information Act
to which I can provide the following response on behalf of Harrogate and
District NHS Foundation Trust.  Completion of the request has been delayed
owing to operational pressures during the Covid pandemic, please accept
our sincere apologies for this delay.

 

1. Do your patients over 50 years old have access to a Fracture Liaison
Service (FLS)?                       
c. No commissioned FLS and no pathway for bone health management of
fracture patients
If you answered ‘no’ (b or c) please move on to question 15.
For those that answered ‘no’ to having an FLS (question 1).

Q2-14 not applicable

15.  What are the reasons you do not have an FLS, or access to an FLS for
your patients?
a. (please specify:) A business case was developed and discussed on a
number of occasions but has not been commissioned.

16. Have you tried to establish a FLS previously?
a. Yes – see 15

17. What has been the barrier/obstacles to implementing a
FLS?                               
a. (Please specify:) FUNDING / STAFFING / LACK OF INVESTMENT IN QUALITY 

 

19. Do you have an osteoporosis service?
b. Not specifically.  All patients who are admitted with femur fragility
fracture have bone health assessment as part of Orthogeriatric service. 
Inpatients who are not seen  by Orthogeriatrics and all outpatients with
fragility fractures do not have access to coordinated falls & bone health
service
20. Do you have a DXA (bone density scanning) service?
a. Yes

21. Please state the name and contact details of the Clinical Leads for
osteoporosis, rheumatology or  musculo-skeletal, services
a. (please specify) Rheumatology  - Dr Cathy Lawson
([3][email address])

22. Are there any areas of support around FLS that you would like further
information/support on from the ROS? E.g. patient info, Clinical
Standards, KPIs, Service Improvement / Patient Information etc
a) (please specify) Not specifically.  ROS helped us develop the second
business case.  FLS info is all easily available on the FLSDB. 

 

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Should you be dissatisfied with this response you are welcome to contact
me again for further information. In addition, under the terms of the
Freedom of Information Act 2000 you are also able to make a formal
complaint regarding the handling of this information request. Your
complaint will be handled in accordance with the Foundation Trust’s policy
on handling complaints. Your complaint should be put in writing and
addressed to the Chief Executive of Harrogate and District NHS Foundation
Trust at Harrogate District Hospital, Lancaster Park Road, Harrogate, HG2
7SX.

 

In addition, if you do not believe Harrogate and District NHS Foundation
Trust has dealt with your complaint properly, you may contact the
Information Commissioner. You should do this as soon as possible or in any
case within two months following the final response of the Foundation
Trust. This can be done online at [5]www.ico.gov.uk or in writing to
FOI/EIR Complaints Resolution, Information Commissioner’s Office, Wycliffe
House, Water Lane, Wilmslow, Cheshire, SK9 5AF.

 

Yours faithfully

 

Freedom of Information Officer

Trust Headquarters | 3^rd Floor Strayside Wing | Harrogate and District
NHS Foundation Trust | Lancaster Park Road |Harrogate HG2 7SX

 

 

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