The Earl of Munster
asked Her Majesty's Government:
Which measures have been undertaken by the Department of Health to ensure that national guidelines on the prevention and treatment of osteoporosis produced recently in co-operation with the Royal College of Physicians will be implemented; and [HL560]
Whether the Department of Health plans to assess to what extent general practitioners have changed their practice in accordance with the recommendations of the guidelines on the prevention and treatment of osteoporosis. [HL561]
§ Baroness Hayman
The osteoporosis strategy, which includes clinical guidelines (to be published by the Royal College of Physicians in March) and a quick reference primary care guide on the treatment and prevention of osteoporosis, is evidence based. It highlights the importance and benefits of targeting action at particularly high risk groups and also includes information that is accessible to the public. It was brought to the attention of all Health Authority chief executives, Directors of Public Health, and Regional Directors of Public Health in England through Health Service Circular 1998/124, with the expectation that these guidelines now be used as the basis for the development of local osteoporosis strategies.
The department continues to work closely with the National Osteoporosis Society (NOS), which was closely involved in the development of the strategy. The NOS conducts regular surveys of health authorities to determine the extent and range of osteoporosis service provision. This work is invaluable to the department in assessing progress in this area.
Thirty thousand copies of the primary care guide have already been ordered, showing that front line service providers are aware of the strategy and ready to follow its recommendations. This should ensure that clinical practice is consistent. Furthermore, the NOS is planning 144WA to survey general practitioners in the next six months to assess the impact of the primary care guide.
The strategy has also been publicised in England, Northern Ireland and Wales through articles in their Chief Medical Officer's Update.
The Department of Health and Social Services (DHSS), Northern Ireland has also publicised the primary care guide through discussion with the medical profession at the Specialty Advisory Committee on General Medicine in October 1998; and through discussion at the General Medical Care Subcommittee of the Central Medical Advisory Committee in November 1998. The DHSS is awaiting the publication of the Clinical Guidelines for Strategies to Prevent and Treat Osteoporosis by the Royal College of Physicians in March before developing guidelines more relevant to services in Northern Ireland.
The Department of Health in Wales is encouraging health authorities to take the guidelines into consideration when developing their strategies on osteoporosis. General practitioners will be expected to approach osteoporosis cases in a way consistent with good practice and the strategy adopted by their local authority. No formal assessment of the guidelines or how they work in practice is planned.
A report in April 1997 by the Scottish Needs Assessment Programme reviewed existing osteoporosis services for prevention, detection and management of the disease. The report, while acknowledging that health boards in Scotland would have to decide the priority to be given to the disease, made a number of recommendations on how services should be applied in primary, secondary and tertiary prevention. The Green Paper Working Together for a Healthier Scotland published in February 1998 recognised the problem in the context of addressing lifestyle issues that cause ill health, in particular the negative effects of smoking and the benefits of physical activity.