The identification of fragility fractures in Wales has doubled, with more than 10,000 patients identified in 2025.
Fragility fracture case identification by Fracture Liaison Services across Wales reached 49.2 per cent in 2025, representing 10,604 patients. Over the same period, treatment rates continued to improve and exceeded the 50% national target, reaching 57.4 per cent.
Osteoporosis affects thousands of people across Wales and is a major cause of fragility fractures, which can have a devastating impact on independence, quality of life, and healthcare services.
Since its establishment in 2020, the Bone Health Clinical Implementation Network (CIN), part of NHS Wales Performance and Improvement, has supported Fracture Liaison Services to considerably improve the identification and treatment of people who experience fragility fractures.
Further improvements made during that time include improving access to bone density (DEXA) scanning, with 1,728 patients receiving a DEXA scan within 12 weeks in 2025, up from 779 patients in 2024.
Long-term adherence to treatment has also shown improvement, with 52-week osteoporosis medication adherence significantly exceeding UK benchmark levels at 31.7% in 2024.
Dr Inderpal Singh, National Clinical Lead for Bone Health in Wales, said: “Over the past five years, Wales has demonstrated what can be achieved through strong collaboration between patients, clinicians, Health Boards, Welsh Government, primary care, and our valued partners, including the Royal Osteoporosis Society.
“Together, we have strengthened osteoporosis services, improved fracture identification and prevention, and increased awareness of the importance of lifelong bone health.
“While we celebrate these achievements and the progress made during this time, we remain focused on the work still to be done. Every person at risk of osteoporosis or fragility fractures should have timely access to assessment, appropriate investigations, and effective, evidence-based treatment and support.”
To support high-quality and equitable care across Wales, the Bone Health CIN has developed and launched both the Osteoporosis and Bone Health Community Health Pathway and the Falls Prevention Community Health Pathway.
The introduction of the Bone Health Quality Statement Audit Tool, which includes automated scoring and quarterly Health Board reporting, is helping services measure performance consistently and drive continuous improvement.
A cornerstone of the workstream's success has been the active involvement of people with lived experience and Royal Osteoporosis Society. Patient representatives have been embedded within the Bone Health CIN, helping to shape pathways, patient information resources, and service development.
National collaboration has also been strengthened through peer learning initiatives and the successful delivery of the National Fracture Liaison Service and Bone Health Conference 2026, bringing together clinicians, managers, patient representatives, and partners from across Wales.
Professor Isabel Oliver, Chief Medical Officer for Wales, said: "Osteoporosis is often not recognised until a fracture occurs, with potentially serious consequences for people’s health, independence and quality of life. The progress being made in Wales in identifying those at risk and improving access to assessment and treatment is therefore very important.
“We now need to build on this great progress so that prevention, early diagnosis and effective treatment become a consistent part of care across Wales. By joining up primary, community and hospital services, and supporting people to protect their bone health throughout life, we can prevent avoidable fractures and help more people remain active, independent and well as they age.”
Ruth Wakeman, Director of Services, Influencing and Innovation at the Royal Osteoporosis Society, added: “As the patient charity for everyone affected by osteoporosis, the Royal Osteoporosis Society warmly welcomes the significant progress made across Wales in improving fragility fracture prevention, osteoporosis care and bone health.
“Many more people are now being identified after a fragility fracture and offered treatment and support which will prevent future life changing fractures and help people maintain their independence and quality of life.
“This shows what is possible when patients, clinicians, health boards and partners work together with a shared ambition. There is still more to do to ensure everyone can access timely diagnosis, treatment and ongoing support for osteoporosis, but Wales has built strong foundations on which to make further progress.”