P077 The Yorkshire Bone Network- why every region needs a Bone Network!
Authors: Vandevelde Claire Y J , Sultan Shabina , Hordon Lesley 
Published: April 2024

Abstract

Background/Aims
The Yorkshire Bone Network (YBN) was formalised in 2019, from a founding group of Yorkshire clinicians with a special interest in osteoporosis, meeting every four months since 1994 to discuss new drugs as they were licensed, the research underpinning them, complex clinical cases and educational topics in osteoporosis. This group was formalised into a Network in order to expand the membership and invite contributions from an increased range of specialists from different disciplines and Trusts across Yorkshire. Further aims were to reach consensus on the management of key osteoporosis issues across Yorkshire and deliver Regional guidelines.

Methods
The YBN now has 35 members from Rheumatology, Endocrinology, Metabolic Bone and Elderly Medicine departments from 12 different Trusts across Yorkshire. Meetings are four-monthly, continuing on Zoom during the pandemic, and now in-person again. Each meeting involves discussion of complex clinical osteoporosis cases for management decisions, alongside an educational or guidelines development session, delivered by a member of the Network or an invited guest speaker.

Results
We have: Agreed a consensus statement on the use of Romosozumab in Yorkshire, specifically covering cardiovascular screening for potential patients. This has given clinicians confidence in identifying appropriate patients and prescribing this new drug. This should also ensure equity of drug access to patients across the region, who are being assessed using the same framework. We have written guidelines on the role of bone densitometry in patients with coeliac disease. This has been provided to local Gastroenterologists, with the aim of reducing unnecessary bone densitometry referrals, reducing the burden on patients and radiology departments. We have provided regional recommendations for the early (before 14 days) administration of IV zoledronate for inpatients post fractured neck of femur, avoiding discharge prior to treatment. This has been adopted and is being audited to assess impact in one of our District General Hospitals. We have provided educational sessions on bone turnover markers, FRAXPlus, glucocorticoid-induced osteoporosis and renal bone disease.

Conclusion
The Yorkshire Bone Network is an excellent example of collaborative working. It is a valuable forum for clinical decision making for complex patients across the region. It has allowed the development of guidelines and consensus statements which are in clinical use, thus minimising variation in patient care across the region and improving clinician confidence. It continues to be an enjoyable way of forming new links between colleagues both within our own Trusts and across the region, with new members joining each year. Time is needed to co-ordinate the meetings, provide minutes and liaise with colleagues but the benefits far outweigh the effort! We would strongly recommend the formation of similar networks across the UK, given the benefits to both patients and clinicians.

Disclosure
C.Y.J. Vandevelde: None. S. Sultan: None. L. Hordon: None.