Osteoporosis New Zealand Strategic Plan 2017 – 2020

Osteoporosis NZ’s Strategic Plan 2017-2020 outlines our future planning to achieve full implementation of BoneCare 2020, our strategy to transform fracture care and prevention in New Zealand.

The Strategic Plan addresses the clinical management of fractures, the prevention of ongoing osteoporotic fractures, as well as raising public awareness to prevent fractures and optimise bone health throughout life.

Click the image below to view the 2016-2020 strat plan.

BoneCare 2020

In December 2012, Osteoporosis NZ published BoneCare 2020 which made the case for implementation of a systematic approach to hip fracture care and prevention in New Zealand. The four key objectives of BoneCare 2020 are illustrated in the Osteoporosis New Zealand ‘Pyramid’ and below. The current status of implementation is also summarised.

Implementation status

Objective 1: New Zealand Hip Fracture Registry

ACC is supporting the New Zealand Hip Fracture Registry as part of a programme of work to improve services for older people.  It would not have been possible to develop the Hip fracture registry without the contributions of a multi-disciplinary team comprised of organisations and health professionals both nationally and internationally.  New Zealand will join a comparatively small, but expanding, group of nations to have implemented a hip fracture registry.

Great news for the 4,000 New Zealanders who break their hip every year.  This is a fantastic resource with a complementary suite of tools.

Trans-Tasman Hip Fracture Guidelines developed by the Australian & New Zealand Hip Fracture Registry were published in September 2014 and are available from http://www.anzhfr.org/.

Clinical Care Standards have been drafted. A high performing IT platform has been developed and successfully piloted in four northern DHBs.

With continued enthusiasm from clinicians, political will and funding support, Osteoporosis New Zealand look forward to participation by all DHBs in the NZ Registry.

Objective 2: Fracture Liaison Services

Fracture Liaison Services (FLS) are models of care which ensure that people who have suffered a fracture caused by osteoporosis receive the care that they need to prevent occurrence of a second fracture. Thus, FLS are concerned with secondary fracture prevention. This is very important because people who have suffered a first fracture are at double the risk of suffering future fractures, as compared with their peers who have not broken a bone. This fragility fracture cycle is highlighted by the observation that half of people who fracture their hip have previously broken another bone as a result of osteoporosis. Pursuant to setting an expectation that all District Health Boards (DHBs) in New Zealand should implement a FLS by 30 June 2014, the Ministry of Health collaborated with Osteoporosis NZ, the 4 regional DHB Alliances, and clinical and administrative staff from the DHBs to deliver FLS Forums to share best practice and experience from overseas during Q4-2013 and Q1-2014. Waitemata DHB was the first to establish an FLS in New Zealand in December 2013. For the health service year July 2014 – June 2015, the District Annual Planning guidance states that DHBs should have fully operational FLS, and that this will be measured quarterly based on:

‘Evidence that the DHB has established a Fracture Liaison Service (FLS) and is monitoring its operation, in particular from the number of people identified as having fragility fractures and the proportion who avoid a secondary fracture.’

Objective 3: Preventing the first fracture

As stated in BoneCare 2020, development of clinically effective and cost-effective systems for prevention of the first fracture caused by osteoporosis – known as primary fracture prevention – will be our focus once objectives 1 and 2 above are achieved. Osteoporosis NZ intends to collaborate with the Royal New Zealand College of General Practitioners to develop these First Fracture Prevention Programmes. Osteoporosis NZ has collaborated with the Health Quality & Safety Commission on the Commission’s Reducing harm from falls campaign. A component of this campaign is The 10 Topics set of learning activities which is intended for anyone involved in the care of older people at risk of falling or interested in how older people can ’keep on their feet’. BoneCare 2020 is featured in Topic 6, related to hip fracture prevention and care. Collectively, The 10 Topics provide an excellent suite of educational resources with direct relevance to prevention of the first fracture.

Objective 4: Public health campaigns

In 2015, Osteoporosis New Zealand intends to conduct a baseline survey to determine the level of public awareness of osteoporosis and the fractures that it causes. This survey will inform the development of subsequent awareness campaigns, the success of which will be assessed by undertaking a repeat of the national survey in 2018. Osteoporosis NZ intends to collaborate with the New Zealand College of Public Health Medicine to develop these campaigns.