Campaigners and healthcare professionals have expressed frustration over the uneven availability of fracture liaison services (FLS) across England’s National Health Service (NHS), with critics saying many regions remain without access to crucial osteoporosis screening and treatment. Despite repeated government promises, roughly half of NHS trusts still lack the specialist clinics designed to diagnose and prevent potentially fatal bone fractures.

The bone clinics provide early checks for osteoporosis in patients considered at risk, often triggered by an initial broken bone. The Royal Osteoporosis Society (ROS) estimates that about 2,000 people die annually from preventable hip fractures, highlighting the importance of early intervention. According to the ROS, one in two women and one in five men over the age of 50 will experience a fracture linked to osteoporosis.

Shadow health minister Caroline Johnson, a consultant paediatrician, visited one of the UK’s leading FLS centres at St Mary’s Hospital, Paddington, part of Imperial College Healthcare NHS Trust. She praised the service there as exemplary, saying it represented “the NHS at its very best” by providing world-class care and helping patients avoid further fractures. However, she expressed anger that such high standards are not consistent nationwide, describing the situation as a postcode lottery.

Johnson criticized the government for failing to meet its commitment to expand FLS services, which have been promised repeatedly since before the July 2024 general election. She said patients urgently need a clear timetable and appropriate funding to ensure universal access. “The government promised results, but all they have delivered is delay and disappointment,” she said.

Former Health Secretary Wes Streeting, who made expanding FLS rollout a key policy, pledged to have these services in place across every NHS trust in England by 2030. This pledge followed a high-profile campaign led by the Sunday Express in collaboration with the ROS and secured cross-party political support. However, critics argue that Streeting’s priorities shifted toward internal Labour Party leadership contests, leaving implementation stalled.

A Department of Health spokesperson reiterated the government’s commitment to achieving nationwide FLS coverage by 2030, as outlined in the 10-year health plan and the women’s health strategy. The spokesperson also noted current investments, including the introduction of 20 new Dexa scanners to improve early bone fragility diagnosis.

Johnson acknowledged the challenges facing current Health Secretary James Murray, stating he inherited the issue from his predecessor but emphasized her belief he could still fulfil the pledge. The ongoing gaps in service have left thousands of people without timely diagnosis or treatment, increasing the risk of potentially disabling or fatal fractures linked to osteoporosis.