Bone Abstracts

Background: Osteoporosis is a growing challenge for the NHS, driven by an ageing population with multimorbidity, fragmented care pathways, limited access to osteoanabolic medications, increasing disability, mortality, and rising healthcare costs. Management is further complicated by financial, cultural, and organisational constraints, with care pathways spanning multiple specialities. Integrated osteoporosis care should therefore be viewed as a Complex Adaptive System that requires multidisciplinary partnerships, collaboration and innovation. Internal audits of hip fracture patients (20152024) identified 10.6% had sustained a previous fragility fracture, 85% were not receiving bone-protective medications at admission, and 9% sustained a further fracture within two years. We piloted digital solutions to improve the identification of fragility fractures, enhance clinical consultations and accelerate treatment initiation.

Methods: Evaluation of the impact of digital solutions on FLS service delivery from January to June 2026 with data from January to December 2025.

Results: 1,210 fragility fractures were managed in 2025. January to June 2026,

• 1,097 Pathpoint Fracture Liaison Service (FLS) consultations were delivered without increasing workforce capacity.

• 561 vertebral fragility fractures were identified through vertebral fracture (VFF) coding, representing a 500% increase in detection; however, maintaining coding compliance remains challenging in high-volume radiology services.

• An Advanced Practice Spine Fragility Clinic was established by reorganising the job plan to meet the increasing demand for vertebral fragility fractures.

• A key system gap remains: there is no integrated Bone Health Multidisciplinary Team (MDT) linking FLS, radiology, rheumatology, geriatrics, oncology, and nephrology, limiting professional interactions, coordinated care and pathway optimisation.

Conclusion: Digital transformation can identify patients earlier, particularly through vertebral fracture detection, and enable timely intervention without additional workforce capacity. Successful implementation requires collaboration and vision between the executive leadership, FLS, other stakeholders and digital teams to support wider adoption of the Pathpoint FLS plaorm, establish an integrated Bone Health MDT, improve access to osteoanabolic and parenteral medications for patients at imminent fracture risk, reduce appointment duplication, and create a Single Point of Access. This collaborative, digitally enabled model provides a scalable blueprint for integrated osteoporosis care within the NHS, improving patient outcomes, service efficiency, and environmental sustainability .