1. Will the First Minister make a statement on the provision of fracture liaison services across health boards in Wales? OQ60990

Yes. Good progress is being made on our commitment to achieve 100 per cent fracture liaison service coverage across Wales by September 2024.

Thank you very much, First Minsiter. Just last week, your Government's Cabinet Secretary for health openly admitted that the NHS in Wales isn't performing well enough, as yet another record was reached on waiting times. According to your recent comments, these waiting times are your top priority, but there are other commitments you'll need to consider in tandem if you're to avoid breaking your promises. In September 2023, the health Secretary issued a statement committing to achieve, as you mentioned, 100 per cent coverage for all health boards by fracture liaison services by 2024. But, unfortunately, First Minister, we're now two thirds of the way through the 18-month timeline set out by the Cabinet Secretary, and only four out of the seven health boards even have these services. Sadly, this is just the tip of the iceberg, as only 21 per cent of fracture patients nationally are being identified in our Welsh NHS, due to underperformance in these services, even where they are now currently in place. As it now looks increasingly unlikely that this target set in February 2023 will be met, can you confirm today whether your Government is still committed to the 100 per cent figure, and, if so, that this will include access for everyone over 50 in Wales to a quality fracture liaison service that meets national clinical standard key performance indicators? Thank you.

We are on track to deliver the commitment made by the Cabinet Secretary for health. I look forward to the new services starting in September to deliver against that commitment. We recognise that fragility fractures can be painful and potentially debilitating. That's why we've recognised the role of fracture liaison services, which provide early Intervention and easy access to osteoporosis care to reduce the risk of such fractures. And much progress has been made since Dr Inder Singh was appointed as the national clinical lead for falls and fragility in 2022. We've come a long way. There's more to go, but we remain on track to meet the commitment given by the Cabinet Secretary for health.

First Minister, on average, women lose up to 10 per cent of their bone mass in the first five years after menopause. Having lower levels of oestrogen increases the risk of developing osteoporosis, so women experiencing the menopause are at an increased risk of broken bones or fractures. The First Minister will be aware that one in two women over 50 will experience a broken bone in their lifetime. Fracture liaison services in all health board areas is a very welcome step forward, but what else is being done to improve bone health and NHS services in Wales?

Thank you for the question. It's an important point to make that we expect that one in two women over the age of 50 will experience a broken bone within that stage of their lifetime. Now, for us, that's both about the two points you make—about bone health and what we look to do to try to make sure that people can make their own choices about how to live well and improve their own bone health, as well as what the NHS does. That's the service model that fracture liaison services represent. It's also, though, about having access to the most up-to-date evidence and treatment support as well. That's why the Royal Osteoporosis Society recognised the decision by NICE—the National Institute for Health and Care Excellence—to make the first new osteoporosis drug treatment available in a decade. That new drug—I'm not going to pronounce the technical name as it's a bit of tongue-twister, with lots of z's in it—has been available in Wales since 2022. It's another example of where new medications are made available, recommended by NICE, in Wales, because of the way that we support that process and, indeed, the way we use our funding. That early access to evidence-based treatment is available all across Wales now. There will, of course, be more that we can do. As we roll out the fracture liaison service, we will learn lessons from its implementation, and I look forward to the Cabinet Secretary for health continuing to update people, in addition to the money that she has found to invest in the service. 

Of course, I welcome the creation of the fracture liaison services across Wales, but could you, First Minister, provide an update on the provision in Powys, where there are no district general hospitals, and how that service will be delivered?

It's a fair point, of course, because we expect all six health boards with secondary care hospitals to be on track to deliver the service by the end of September. Four already have that service. The other two we expect to be on track to deliver in September, meeting the commitment made by the Cabinet Secretary for health. There is a different model being developed in Powys because it doesn't have secondary care hospitals. So, in that unique position, Powys are working with neighbouring health boards to make sure that the population of Powys have access to that service. So, the model needs to deliver not just in the six health boards that have the hospital provision, but equitable care and access to it for residents in Powys, and we're on track to do so. Powys, of course, is used to having to provide these services in a different way—to commission and organise services within Wales and, indeed, sometimes across the border. So, we're clear that the pathway should be in place for people living in Powys to have the same equitable access to the same quality of care and the improvement that this service represents.