Celebrating NHS Western Isles’ Fracture Liaison Service as we approach World Osteoporosis Day 

As we approach World Osteoporosis Day on October 20, NHS Western Isles is celebrating its Fracture Liaison Service (FLS) and the consequential steady decline in the hip fracture rate in the Western Isles, despite a population that is ageing at a faster rate than in Scotland as a whole. 

Over 3.5 million people in the UK are living with Osteoporosis, a condition that causes bones to lose strength and become more likely to break (fracture). Over half of all women and a fifth of men over the age of 50 in the UK will suffer at least one fragility fracture due to poor bone health (source: Royal Osteoporosis Society). 

Among the most serious of fragility fractures are those of the spine and the hips. In the UK, hip fractures come second only to pneumonia in the number of emergency bed days in hospital taken up each year, and treatment of hip fractures alone costs over £1 billion pounds annually in the UK (Source: Fragility Fracture Network). 

As well as the economic costs of hip fracture, the personal impact on patients is considerable. Eighty per cent of patients who sustain a hip fracture will be unable to return to their pre-fracture level of independence and around a quarter will die within one year after a hip fracture. 

World osteoporosis day aims to raise awareness of Osteoporosis and fragility fracture risk. With diagnosis, simple lifestyle measures and ever improving treatments up to 25 per cent of hip fractures and 40 per cent of all fragility fractures in people over 50 can be prevented. 

One very effective system for identifying those at greatest risk and initiating treatment early is a Fracture Liaison Service (FLS), which is internationally recognised as a gold standard model of care for those over 50 who have already sustained one low impact fracture. By intervening at the first fracture treatment can be started to reduce the risk of further, potentially more serious, fractures. 

NHS Western Isles established a Fracture Liaison Service in 2019 with the appointment of Shuna Mighton, Fracture Liaison Service Practitioner.  

Since then there has been a steady decline in the hip fracture rate in the Western Isles. In 2022, the Western Isles hip fracture rate dipped below that of Scotland as a whole, which is encouraging early evidence of the success of our FLS at preventing serious fractures. 

NHS Western Isles Fracture Liaison Service Practitioner, Shuna Mighton, said: “Those who have not yet sustained a fracture can take simple lifestyle measures to keep their fracture risk as low as possible. Stopping smoking (or never starting), keeping alcohol intake within 14 units/week, regular weight bearing exercise, following a diet rich in calcium and taking vitamin D (especially in winter) can all help. 

“Some medical conditions and some medications are also associated with an increased risk of osteoporosis. Those who are concerned about their osteoporosis risk can use the Royal Osteoporosis Society’s online risk checker Osteoporosis risk checker (theros.org.uk). If an increased risk is indicated, then GP surgeries are able to do a formal risk assessment and to refer for a diagnostic bone density scan if required. A bone density scan (DXA) is totally non invasive and can be done in Western Isles Hospital. This gives a very good assessment of future fracture risk and if treatment is required it can also be used to select the best treatment for the individual and to follow up on its effectiveness.” 

Those with osteoporosis can be understandably concerned about managing fracture risk and falls risk. Some useful resources for reducing falls and fracture risk can be found at 

Paths for All: Strength and balance exercises | Paths for All 

Royal Osteoporosis Society: Osteoporosis information and support | Royal Osteoporosis Society (theros.org.uk)