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More fracture liaison nurses needed

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Specialist fracture liaison nurses should be appointed in every area of the country in a bid to reduce the number of falls among older people, a report has recommended.

The document, compiled by the charities Age UK and the National Osteoporosis Society, said the number of UK admissions for hip fracture was forecast to have reached 140,000 per year by 2036 – double the number in 2008.

However, currently only about a third of England is served by a dedicated fracture nurse who works with hospitals and GPs to identify at risk patients and prevent them from suffering a future injury.

The report – Breaking Through: Building Better Falls and Fracture Services in England – calls on all commissioners to dedicate sufficient “time and resources” to fracture liaison nurses.  

It highlighted a current lack of knowledge of osteoporosis among staff working in care homes and a lack of emphasis on prevention in comparison to rehabilitation.

It said patients were often only identified as at risk after they had been admitted for a serious injury like a hip fracture when action could have been taken earlier when they presented earlier with something less serious like a wrist fracture.

The report was presented to health minister Paul Burstow last week at Guy’s and St Thomas’ Foundation Trust, which runs an osteoporosis and falls screening service.

Finbarr Martin, a consultant geriatrician at the trust, said specialist nursing was the “lynchpin” of the trusts prevention approach.

All patients that attend the fracture clinic are screened by the specialist nurse and surgeons for risk factors. If identified as at risk patients are offered an in depth assessment, including bone scans and blood tests. 

The report was welcomed by Mr Burstow who said preventative action was “critical to turning the rising tide of hospital admissions and costs”.

Royal College of Nursing older people’s adviser Nicky Hayes welcomed the focus of the report. She told Nursing Times all nurses could contribute to falls prevention, but dedicated resources were needed for specialist input.

“Nurses can spread the basic message around falls prevention but if you want to do any more screening there has to be time to do it,” she said.

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