Levers for change

Best Practice Tariff for hip fracture (BPT): The BPT was launched in April 2010 to incentivise delivery of the hip fracture component of the DH Prevention Package. The BPT offers an incentive (of £445 per patient in 2010/11, rising to £890 per patient in 2011/12) when surgery is conducted within 36 hours of admission in combination with provision of effective ortho-geriatrician led medical care of the acute phase. BPT also requires hospitals to ensure that falls risk and bone health assessments are undertaken for all hip fracture patients, aiming to prevent secondary fractures. The 2011 NHFD Report will present data on the impact of the first whole year of the BPT
Commissioning for Quality and Innovation: In November 2010, the Department of Health published a set of exemplar goals for the Commissioning for Quality and Innovation (CQUIN) payment framework. These included specific reference to establishment of Fracture Liaison Services in the acute sector (referred to as Fracture Prevention Services in the document)
Quality and Outcomes Framework: The Quality and Outcomes Framework (QOF) is a voluntary incentive scheme for GP practices in the UK that rewards high quality care. Three indicators relating to osteoporosis and fragility fractures are being considered for inclusion in the 2012/13 QOF:
- Produce a register of patients aged 50 – 74 years with a fragility fracture, with a diagnosis of osteoporosis confirmed on DXA scan (the register will be prospective)
- Percentage of patients aged 50 – 74 years, with fragility fracture, in whom osteoporosis is confirmed on DXA scan, are treated with an appropriate bone-protecting agent
- Percentage of patients over the age of 75 with fragility fracture are treated with an appropriate bone-protecting agent

The Breaking Point Report provided a snapshot of the current situation for women with osteoporosis in the UK.

Breaking Point described the practical steps that must be taken by healthcare professionals, policy makers and commissioners, as well as the public to prevent avoidable suffering and cost of osteoporotic fractures.

Politicans
In May 2011, national audit revealed that almost two-thirds of localities are not implementing Department of Health policy to prevent hip fractures. Learn how you can ensure your constituents are receiving the best quality care.
HCPs
Fracture begets fracture; half of hip fracture patients suffer a prior fragility fracture before breaking their hip. Fracture Liaison Services have been shown to delivery effective secondary preventive care, but most localities don’t have these services.
Commissioners
Hip fractures cost the UK economy £2 Billion per year which translates to £10 million per year for the average locality. Up to a quarter of hip fractures could readily be prevented if the right models of care were commissioned.
Patients
Simple and effective tools are available to your doctor to assess your risk of suffering a fragility fracture. If you are concerned about osteoporosis find out what you can do.

Amgen and GSK have sponsored the production of this web page. Sponsorship has included payment for a medical writer and payment to a public relations agency in respect of project management support.

Levers for change

Politicans

HCPs

Commissioners

Patients