NHS 'fails victims of bone disease'

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The Independent Online

Health Editor

More than half of all health commissions in the UK are ignoring government advice on osteoporosis, a crippling bone disease which blights the lives of hundreds of thousands of middle-aged and elderly people, it was claimed yesterday.

The first nation-wide survey of the availability of screening, treatment, and prevention strategies for osteoporosis has revealed widespread failure to tackle the problem, despite its high profile on the national health agenda.

A total of 13 per cent of commissions admitted they were doing nothing at all to manage osteoporosis, while a further 42 per cent provided a minimum service only for their populations.

Only 12 per cent of health commissions are meeting Department of Health targets of at least 600 bone scans for the disease each year. However, although 55 per cent said they had access to a bone scanner, less than half of these were funding scans.

The National Osteoporosis Society, which conducted the survey, in which 80 per cent of health commissions - formerly health authorities - took part, said that a year after the Government's Advisory Committee on Osteoporosis issued a blueprint for the management of the disease in the NHS, 62 per cent of commissions did not have an overall strategy for tackling it. Fifty-seven per cent had no investment plans for establishing even basic clinical services in their area.

The society said that a basic service could be set up for just pounds 50,000, less than the cost of treatment for two weeks' worth of hip fracture cases in any health district in the country. The annual cost to the NHS of treating osteoporosis and its effects is estimated at pounds 750m at least.

Osteoporosis is the loss of bone mass and deterioration of bone tissue usually associated with the menopause. It results in frequent fractures, crumbling vertebrae and loss of height, as well as constant pain.

One in three women suffer from the disease, and it is responsible for a third of orthopaedic bed occupancy in NHS hospitals. More women die from osteoporosis and its complications than from cancer of the ovaries, uterus and cervix combined - around 40 a day. But men are also affected, with an estimated one in 12 middle-aged men suffering the effects from osteoporosis.

There is no cure, but preventive treatment, early diagnosis, and treatment with drugs and hormone replacement therapy can alleviate its worst effects.

Linda Edwards, director of the NOS, who launched the survey, said: "Health commissions have had a year to implement the recommendations of the Advisory Group on Osteoporosis Report, yet many have chosen to ignore that advice.

"It is a scandal that lack of action is condemning thousands of men and women to a life destroyed by fractures, pain, and deformity. Hundreds of thousands of people could avoid the disease altogether if they received better advice on prevention and earlier treatment."

John Studd, NOS chairman and consultant gynaecologist at the Chelsea and Westminster Hospital, London, said: "We now know how to diagnose and treat osteoporosis effectively and how to identify men and women who are at high risk of developing this disease.

"However, unless health commissions provide clinicians with appropriate local guidelines to improve treatment and prevention and unless they provide the funding support and facilities they need, all this knowledge is going to waste."