1. FLS Implementation – A National Approach
Claire Severgnini
CEO
Thursday 21st January 2016

2. together for a brighter future
Our vision
is a future
without
fragility fractures
Our mission is to work
together for a brighter future
for people with or at risk of osteoporosis and fragility fractures across the UK, putting an end to preventable broken bones and helping people to live without pain and disability
Our aims are:
1) To prevent future fractures
2) To help and support people with osteoporosis now
Our vision
Our ultimate ambition
Our core values
We are caring, innovative, excellent, influential, ethical and passionate in all that we do
Our mission
The strategy that will make our vision a reality
Our current aims

3. National Osteoporosis Society Priorities and Plans for 2015
Aim 1: Every person aged over 50 who breaks a bone is assessed for osteoporosis and managed appropriately. Priority 1: Extend coverage of Fracture Liaison Services Priority 2: Improve quality of Fracture Liaison Services and osteoporosis services

4. Implementation Resources
UK FLS Clinical Standards
FLS Implementation Toolkit
Fracture Prevention Practitioner (FPP) Training
Peer Review 4

5. A National Approach to FLS
FLS Implementation Group
UK FLS Clinical Standards
FLS Implementation Toolkit
FLS Implementation Workshops
Tailored Local Support
Benefits Calculator
Fracture Prevention Practitioner (FPP) Training
Peer Review
Service Delivery Team 5

6. FLS Implementation Group
National stakeholders & Government
Provide strategic leadership and coordination across projects
Ensure good communication and partnership across FLS stakeholders
Plan and deliver agreed actions and milestones
Ensure resources are agreed to enable high quality, efficient and cost-effective FLS

7. Definition of an FLS
‘‘A Fracture Liaison Service (FLS) systematically identifies, treats and refers to appropriate services all eligible patients aged over 50 years within a local population who have suffered a fragility fracture, with the aim of reducing their risk of subsequent fractures.’’

8. UK FLS Clinical Standards
The 5IQ approach describes the key objectives of an FLS:
Identification
Investigation
Information
Intervention
Integration
Quality

9. FLS Implementation Toolkit
Promotes commissioning of effective high-quality services that are integrated within a system-wide approach
Ensures services are in accord with the evidence base and able to demonstrate outcomes
Stimulates provision of services that are sustainable
Make implementation easier, cheaper and more effective for commissioners and providers.

10. What Investment is Required?
Cost of staff required:
Consultant
Nurse specialist
Clerical/admin
Set up costs – FLS accommodation, IT, DXA scanner and other associated costs:
DXA scans/reporting
Other diagnostics
Drug costs

11. FLS Benefits Calculator
Additional resource within the FLS-IT
Designed for use by hospitals, community services and commissioning organisations to help develop an FLS
Estimates the benefits in terms of reduced fragility fracture incidence and cost savings that can be realised in a local health economy as a result of implementing an effective FLS.

12. Fracture Prevention Practitioner Training

13. Fracture Prevention Practitioner Training
Endorsed by:

14. Peer Review
A means of assessing clinical care against agreed standards
Addresses agendas of clinical governance, practitioner revalidation, and service development
Facilitates a quality assured level of care for patients with osteoporosis and metabolic bone diseases. 

15. How the Charity Supports Implementation
Facilitate stakeholder engagement
Help establish patient/care pathway
Project manage commissioning/funding:
The economic and business case
Service specification
Resource and capacity planning
Work with commissioners to ensure services are sustained.

16. How the Charity Supports Implementation
Provide input to enable the development of an FLS meets the UK FLS Clinical Standards
Help establish data collection, analysis, evaluation and reporting
Identify gaps in service provision, put in place improvement plans and monitor against agreed actions
Peer review

17. FLS Mapping

18. Implementation from no service No. of services commissioned
Activity in 2015
Aim 1:
Every person aged over 50 who breaks a bone is assessed for osteoporosis and managed appropriately.
Priority 1:
Extend coverage of Fracture Liaison Services
Priority 2:
Improve quality of Fracture Liaison Services and osteoporosis services
Contact made
Implementation from no service
Quality improvement
No. of services commissioned
Total sites
Peer support
Commissioning 43 42 37 23 7*
145

19. FLS Benefits Area Population Cohort (50+) Hip fractures prevented*
Total benefits (of hip fractures prevented)*
Bradford
459,142
129,011
119
£1,960,644
East Sussex
374,801
167,905
188
£3,097,488
Epsom
405,456
119,974
115
£1,894,740
Rotherham
258,751
96,591 66
£1,111,902
Salisbury
144,835
59,786 59
£972,084
Stoke-on-Trent
214,991
88,334 88
£1,449,888
Vale of York
348,363
131,411
128
£2,108,928
Total
2,206,339
793,012
763
£12,595,674
*Over a 5 year period

20. “You must be the change you wish to see in the world.”
Mahatma Gandhi

21. Service Delivery Team Tim Jones Commissioning Advisor Sonya Stephenson
Service Development Project Manager
Jo Sayer
Service Development Project Manager
Hilary Arden
Head of Service Delivery
Will Carr
Service Development Project Manager
Mayrine Fraser
Service Development Project Manager
Debbie Stone
Service Development Project Manager
Henry Mace
Professional Development Lead
Fiona Gardner
Operation Projects Officer

22. FLS Implementation – A National Approach
Claire Severgnini
CEO
Thursday 21st January 2016