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.