Richard had a fall downstairs at home and was left with chronic back pain. Following scans and an x-ray he was diagnosed with osteoporosis at the age of 58. Richard describes his experience of living with bone fragility and his care and treatment since diagnosis:
“After I found out I had osteoporosis I was a little bit shocked – I knew I was getting on a bit but I never expected something like this. I had to have regular hospital appointments and was given tablets to strengthen my bones and reduce the risk of fractures. Taking the Alendronic acid tablets was awful. I had to remember to take them once a week, early in the morning on an empty stomach with two glasses of water – I was then unable to lie down or eat/drink for a while after taking the medication. The pills also caused a number of unpleasant side effects which I found painful and difficult to manage.
“I talked to the consultant at the hospital about this and she referred me to a new community service where they provide an alternative intravenous treatment instead. I had the IV treatment at my local health - it was such a positive experience. The nurse took on board my anxiety about needles and having a drip - she chatted to me the whole time to distract me!
“The treatment lasts about half an hour and I only go back every 18 months which is much better than having to remember to take pills every week and going to the hospital. I can even book a late afternoon appointment to fit round work commitments. I don’t use the NHS a lot but it’s wonderful when the service is so good when you do need it.”
Moving services closer to home
The community Fracture Liaison Service has been rolled out across three areas in South Nottinghamshire with more patients now receiving the ongoing treatment they need for their osteoporosis at their local health centre or at home instead of going to the hospital. A specialist nurse working with the service explains the impact this is having on both patients and the local NHS:
“The service was designed in partnership by a local GP and a consultant at the hospital to improve patients’ experience of treatment and reduce their chances of suffering future fractures due to osteoporosis.
“Providing this new service in the community has also helped reduced costs in just one area of Nottinghamshire by more than £100,000 in the first two years - through savings on drug and administration costs. If we can continue to treat more patients in this way and prevent future fractures then we can save the NHS a significant amount of money. We know that the treatment and care required following a hip fracture costs the NHS around £20,000 per patient - as well as impacting people’s quality of life and through loss of mobility and independence. So there are also savings through providing preventative treatment to those most at risk. This is thought to be the first service of its kind in the country and the opportunity to improve care and prolong people’s independence - whilst also making much needed efficiency savings - is huge.
“To prove the service was worth continued funding and rolling out to other areas, it was important that it was evaluated for clinical effectiveness but also audited for quality. We ask all patients to complete a questionnaire about how easy they find it to access the service and their personal experience of the treatment itself. This information has helped us adapt the care we provide to reflect the views and needs of patients.
“The response from patients has been incredibly positive, particularly around the compassionate and personalised care provided, and the time taken to explain the treatment and answer questions. Patients have described the service as being ‘calm, friendly and kind’ and say they are ‘over the moon’ at not having to travel to hospital as they can be seen closer to home and in a less overwhelming environment.”