Campaigners are dismayed at the lack of services in England to spot and treat osteoporosis at an early stage – and now there are worries about bone health in Scotland as well. Scotland blazed a trail in the developing “fracture liaison services” which specialise in spotting warning signs that someone may have the dangerous disease.

There are now worries there may be significant gaps in provision and the Royal Osteoporosis Society wants the findings of a promised audit of services published. It is feared almost 200,000 people in Scotland are living with undiagnosed spinal fractures. The charity claims osteoporosis affects around 250,000 people in Scotland, with fractures the “fourth worst cause of premature death and disability in Scotland”. Half of women over 50 and one-fifth of men are expected to break a bone due to osteoporosis.

Pam Duncan-Glancy, a Labour member of the Scottish Parliament and convener of the cross-party group on arthritis and musculoskeletal conditions, said: “It’s regrettable that the Scottish Government has failed to deliver on its commitment to implement a national audit of Fracture Liaison Services. The audit would assess the performance of these clinics to ensure more patients receive timely and appropriate treatment...

“The failure to deliver on this commitment means patients are still navigating a postcode lottery in service provision. The Scottish Government must now deliver this national audit at pace”.

Craig Jones, chief executive of the Royal Osteoporosis Society, warned: “We’re getting increasingly worried about the scale of avoidable deaths and disability in Scotland, owing to the weaknesses in coverage and quality of fracture services, but these gaps remain hidden from politicians because there’s no audit. Two years ago, Ministers agreed to audit these services, but still nothing has changed.

“Today, the Scottish Government seems unwilling even to say that 100% coverage of these life-saving services is their policy, unlike the Governments in England and Wales. Scotland was the birthplace of modern fracture care, inspiring bone services in 57 countries, so this slip-back is a huge shame, and we appeal to Scottish Ministers to work with us to reverse it.”

A Scottish Government spokesperson said: “We recognise the importance of identifying, assessing and offering treatment to those at the highest risk of preventable fractures. “We have commissioned Public Health Scotland to deliver an audit of fracture liaison services with the aim of driving improvement and reducing variation in practice across Scotland.”