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RheumatologyClinical services

Osteoporosis

Almost one in two women and one in five men over the age of 50 will break a bone, mainly due to osteoporosis. It can also affect children, although this is rare.

Why choose us?

We are a leading centre for the treatment, diagnosis and management of osteoporosis and those at increased risk of fracture. We have a wide range of specialist staff providing high-quality treatment based on best practice and research. 

Our multidisciplinary team is led by Dr Ashok Bhalla, consultant rheumatologist specialising in osteoporosis and metabolic bone disease, and includes specialist registrars, a specialist osteoporosis nurse, a clinical scientist and radiographers. They are supported by specialist physiotherapy, occupational therapy, podiatry, dietetic, orthotic and laboratory services.   The team has established expertise in osteoporosis and sees an average of over 300 patients per month.

What we offer

We provide services for adults on an inpatient basis (i.e. for control of pain, poor mobility or for multiple investigations), or an outpatient basis. In addition, we provide a paediatric osteoporosis clinic which is held jointly by Dr Bhalla and our consultant paediatric rheumatologist.

Initial treatment is usually oral medication, but if this is unsuitable there are alternatives including:

  • IV bisphosphonate therapy Our infusion clinic runs daily for patients requiring intravenous bisphosphonate therapy. For the criteria for IV bisphosphonate therapy, please click here.
  • anabolic therapy The use of parathyroid analogues is effective in patients who cannot tolerate bishosphonates or for whom they are not effective
  • newer treatments Denosumab twice yearly subcutaneous injections are NICE approved and now available. For BCAP Shared Care Guidelines please click here.

Patient education

The team provides osteoporosis patient education programmes for patients with osteoporosis or low bone mass who wish to find out more about their condition. The team is headed by the osteoporosis nurse. The aim of the sessions is to provide people with the information and tools to help them manage their condition effectively. Patients will also have the chance to meet other people with the same condition and share their experiences.

Our hospital in conjunction with DIPEx (Database of Individual Patient Experiences UK) based at the University of Oxford have developed a patient information resource providing information about osteoporosis treatments and patient experiences. To read more click here.  

Falls and fracture liaison service

The aim is to ensure that the long-term healthcare needs of patients with fragile bones who have had a low trauma fracture (one that occurs from a fall from standing height or less), or at risk of falls, are identified and addressed. Opportunities to identify these patients often arise during a hospital attendance. Having identified the patient, recommendations are made to their GP about appropriate healthcare pathways. This proactive approach should reduce both the number of people who fall and the proportion of falls which result in a fracture, thereby reducing the number of hospital admissions due to falls, with corresponding improvements in health and quality of life.

How to access our services

We accept local and national referrals for adults and children. GPs, consultants or specialist healthcare professionals may refer patients to the osteoporosis clinic either in writing or via Choose and Book. A letter should be sent providing relevant details to Dr Ashok Bhalla, consultant rheumatologist. 

Please note that there is also the option to refer patients for a bone mineral density measurement, without a clinic consultation. As a result of this measurement some patients will be recommended to be seen in clinic for further assessment. However, GPs wishing to refer patients for consideration of the second-line osteoporosis treatments listed above will need to refer the patient to the osteoporosis clinic.

A period staying on a ward as an inpatient may be required by some patients. GPs may request an inpatient stay for a patient where there is a clinical need to do so. 

For more information or referral advice tel 01225 473443, fax 01225 473437