GP-led fracture prevention scheme could save NHS millions of pounds

An early prevention scheme for bone fractures trialled successfully by a GP federation in Northumberland could be rolled out nationwide to help slash the £2.3bn annual cost of fractures to the NHS.

Falls: scheme aims to protect at-risk patients (Photo: JH Lancy)
Falls: scheme aims to protect at-risk patients (Photo: JH Lancy)

By identifying people at risk of falls and prescribing calcium and vitamin D therapy, the federation estimates that it has prevented 18 hip fractures in the past year, saving an estimated £175,000.

Hadrian Primary Care Alliance, a federation of 13 GP practices in West Northumberland, offered 984 of its 78,000 patients preventative calcium and vitamin D therapy as part of the Improving Bone Health and Falls Prevention project.

Dr Emily Hadaway, GP Partner at Haydon Bridge and Allendale Medical Practice, says that the project has been ‘immensely useful’.

‘There’s a need for more communication and understanding with patients at risk of fractures, because of the morbidity and mortality that often follows on from them,’ she told GP.

Fracture risk assessment

A pharmacist visited each practice for half a day and collated a list of patients who were at risk of fractures, such as older adults and people with osteoporosis, who would benefit from calcium and vitamin D treatment.

The GP lead from the practice reviewed the list and decided which patients should be receiving the treatment.

Interface Clinical Services, who run medical projects, then sent letters to these patients informing them about their risk of fractures and inviting them in to collect a prescription or contact their GP.

‘We gave them the appointment to discuss it if they wanted to, but it was something they could start without coming into the practice, so it wasn’t increasing our clinical workload,’ said Dr Hadaway. ‘Only six patients from our practice came in to discuss it.’

Dr Hadaway believes that the project has improved communication with patients in an area that can be easily overlooked.

‘There’s not a good degree of communication of the importance of taking the medication,’ she said. ‘With preventative medicines, there’s not an immediate benefit to the patient and there’s a lack of understanding about the significance of the fracture – it doesn’t sound as serious as other aspects of care like heart disease and cancer.’

The project has also helped to identify 209 patients in the federation who could be included on QOF registers.


The initiative is going to be rolled out across the county and the auditing process can also be applied to other areas such as COPD or stroke prevention, the project leaders say.

‘It’s been a really innovative way of providing healthcare to our population, and we found it a successful way of working, so we’re hoping to be able to explore that in other areas of Northumberland or wider,’ Dr Hadaway said.

Jill Mitchell, the fractures programme lead, said: ‘The significance of this project extends far beyond West Northumberland. This is just one small area, the programme can be rolled out across any GP practice or federation throughout the UK.’

The Academic Health Science Network for the North East and North Cumbria (AHSN NENC), who ran the project, are now looking for other groups of practices to take part in its roll-out and extension.

For more information, contact Jill Mitchell:

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