Preventing Falls and Transforming Bone Health in Wales

The colder months bring unique challenges for many people in Wales, particularly those at risk of falls and fractures. At Aneurin Bevan University Health Board, the dedicated Fracture Liaison Service (FLS) team is working to reduce these risks and support patients.

Osteoporosis is a common condition that weakens bones, making them more likely to break, a problem often put more at risk during icy winter months. Across Wales, over 20,000 fractures occur each year, including more than 4,000 hip fractures, many of which lead to pain, disability, or a loss of independence. Alarmingly, if left untreated, there is a one-in-three chance of a second fracture within just 12 months, creating what clinicians call a “fracture cascade.”

The importance of intervention and prevention cannot be understated with thanks to innovation of services like the FLS, the risk of subsequent fractures can be reduced by as much as 40%. The Health Board’s FLS is led by specialist consultants, supported by a team of Clinical Nurse Specialists (CNS) and supporting staff who work collaboratively to identify, treat, and support patients with fragility fractures. 

The team identifies patients over the age of 50 who have had fragility fractures. Once identified, patients receive a comprehensive health assessment over the phone, allowing the team to determine the best course of action. The service doesn’t stop at diagnosis. Patients who are found to be at high risk of future fractures are supported with a holistic plan that includes tailored treatments, lifestyle advice, medication and regular follow-ups.

Dr Shannon Rowlands said: “If a patient has a fracture, they're probably at more risk of having one in the future. So it's important for us to identify those patients that need a bit more support and then treatment to make sure that they lessen their chances of having one in the future.

"The service is great because there hasn't been probably anything in the system before this. Patients wouldn't have had this phone call otherwise. They wouldn't have had a nurse to check on their health in general, as well as their bones. So I think it's a nice holistic approach and hopefully it makes patients feel empowered to take care of their health as well.”

The impact of the FLS in Gwent has been remarkable. Evidence shows that a well-functioning FLS can identify twice as many patients at risk of fragility fractures compared to areas without such services, ensuring that more than 50% of them receive appropriate bone health treatment. For patients in the Gwent region, this means fewer fractures, less time spent in hospital, and most importantly, a better quality of life.

Dr Inder Singh, Consultant Physician & Geriatrician for Falls and Bone Health said:

“The impact of fragility fractures goes beyond physical injury, with a loss of independence and fear of further fractures. These fractures cost the NHS £4.7 billion annually, including £133 million in Wales, placing increasing demands on health and social care. If somebody has a fracture, there’s a one-in-three chance they will sustain another within 12 months.

“A simple self-care plan, including staying active, eating well, and recognising fall risks, can make a real difference.” 

By identifying patients early, offering tailored interventions, and empowering individuals to take charge of their health, the FLS team is ensuring that the rest of winter does not have to mean a season of risk and worry for those with fragility fractures or osteoporosis.

The Fracture Liaison Service is a shining example of what can be achieved when a passionate, skilled team comes together with a clear mission: to prevent fractures, improve lives, and build healthier futures for all. 

Find out more here 

Written Statement: Quality Statement for Osteoporosis and Bone Health (6 December 2024) | GOV.WALES

Or learn more about the service here 

Fracture Liaison Service (FLS) - Aneurin Bevan University Health Board