Claire Severgnini speaking about our newly launched calculator to help CCGs see how much they could save when they implement a Fracture Liaison Service. This event is aimed at CCGs wishing to maximise value for their populations, providers who wish to work with us to transform the delivery of Musculoskeletal (MSK) services and key members of the MSK community, including local clinical champions. The event will build on and consolidate the MSK Knowledge Network which was launched in September 2015. The seminar will support CCGs to: - improve outcomes, increase value and reduce wastage in your local MSK economy; - access the best national expertise to drive improvement in key areas including metrics and workforce; - learn how to set up effective MSK clinical networks; and - find out practical solutions and learn from the experience of others.

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

2. 2
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 core values
We are caring,
innovative,
excellent,
influential, ethical
and passionate in
all that we do
Our vision
Our ultimate
ambition
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. • UK FLS Clinical Standards
• FLS Implementation Toolkit
• Fracture Prevention Practitioner (FPP)
Training
• Peer Review
Implementation Resources

5. • 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
A National Approach to FLS

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 www.nos.org.uk/fls

9. 9
FLS Implementation Toolkit
1. Promotes commissioning of effective high-quality
services that are integrated within a system-wide
approach
2. Ensures services are in accord with the evidence
base and able to demonstrate outcomes
3. Stimulates provision of services that are
sustainable
4. 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. 12
Fracture Prevention Practitioner Training

13. Fracture Prevention Practitioner Training
Endorsed by:
www.nos.org.uk/fpp

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

16. • 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
How the Charity Supports
Implementation

17. 17
FLS Mapping

18. 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. 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
Sonya Stephenson
Service Development
Project Manager
Will Carr
Service Development
Project Manager
Hilary Arden
Head of
Service Delivery
Tim Jones
Commissioning
Advisor
Mayrine Fraser
Service Development
Project Manager
Debbie Stone
Service Development
Project Manager
Fiona Gardner
Operation Projects
Officer
Henry Mace
Professional
Development Lead
Jo Sayer
Service Development
Project Manager

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