A renewed call to include osteoporosis in the GP Quality and Outcomes Framework has been made in a report published yesterday by the British Orthopaedic Association and the British Geriatric Society.
Osteoporosis is the most common disease of bone and its incidence is rising rapidly with an ageing population. But, according to the groups’ revised Blue Book (a guide to best practice in the care of fragility fractures), although the disease is treatable, it is often left untreated. And this is mainly because organisation of services is poor, “with little recognition of the nature of osteoporosis as a long-term condition,” it says.
Over 300,000 patients are hospitalised with fragility fractures each year, with medical and social care costs – mostly relating to hip fracture care – hitting £2 billion. But the reports warns that current projections indicate that the incidence of hip fracture will rocket from the estimated 70,000 per year to 91,500 in 2015 and 101,000 in 2020, thus placing a further strain on the National Health Service’s coffers.
Better coordinated services, it says, such as early diagnosis and bone protection, optimal fracture care and secondary prevention, would improve quality of life for patients and reduce the burden on services of fracture care. But, surprisingly, osteoporosis and fractures are not included in the QOF - an annual, performance-based reward and incentive scheme for GPs introduced in 2004 and currently under review – and so practices have limited activity in these areas and data recording is often poor, the report stressed.
QOF codes to better care
Earlier this month, the first national evaluation of standards of care for osteoporosis and falls in primary care suggested that adding an appropriate set of codes for the condition into the QOF could help better care.
The report, which was based on a survey conducted by the information centre, suggests that low levels of achievement are partly due to practices not entering assessments or referrals that have been carried out on a patient’s electronic medical record, and that giving osteoporosis its own slot in the QOF could boost both the provision of care and recording of relevant information.
This also follows research by pharmacists in Northumberland which found that half the women who are at risk of bone fractures do not receive preventive treatment as recommended by the National Institute of Health and Clinical Excellence.