FLS Implementation – A National Approach
Thursday 21st January 2016
Claire SevergniniCEO
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Our vision is a future without fragility
fracturesOur 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 valuesWe are caring,
innovative, excellent,
influential, ethical and passionate in
all that we do
Our visionOur ultimate
ambition
Our missionThe strategy
that will make our vision a
reality
Our current aims
National Osteoporosis SocietyPriorities and Plans for 2015Aim 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
• UK FLS Clinical Standards• FLS Implementation Toolkit• Fracture Prevention Practitioner (FPP)
Training• Peer Review
Implementation Resources
• 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
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
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.’’
UK FLS Clinical StandardsThe 5IQ approach describes the key objectives of an FLS:
• Identification
• Investigation
• Information
• Intervention
• Integration
• Quality www.nos.org.uk/fls
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FLS Implementation Toolkit1. 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.
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
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.
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Fracture Prevention Practitioner Training
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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.
www.nos.org.uk/peer-review
• Facilitate stakeholder engagement• Help establish patient/care pathway• Project manage commissioning/funding:
o The economic and business caseo Service specificationo Resource and capacity planning
• Work with commissioners to ensure services are sustained.
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
How the Charity Supports Implementation
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FLS Mapping
Activity in 2015Aim 1: Every person aged over 50 who breaks a bone is assessed for osteoporosis and managed appropriately.Priority 1:
Extend coverage of Fracture Liaison ServicesPriority 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
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FLS BenefitsArea Population Cohort
(50+)Hip fractures prevented*
Total benefits (of hip fractures prevented)*
Bradford 459,142 129,011 119 £1,960,644East Sussex 374,801 167,905 188 £3,097,488Epsom 405,456 119,974 115 £1,894,740Rotherham 258,751 96,591 66 £1,111,902Salisbury 144,835 59,786 59 £972,084Stoke-on-Trent 214,991 88,334 88 £1,449,888Vale of York 348,363 131,411 128 £2,108,928Total 2,206,339 793,012 763 £12,595,674*Over a 5 year period
“You must be the change you wish to see in the world.”
Mahatma Gandhi
Service Delivery Team
Sonya StephensonService Development
Project Manager
Will CarrService Development
Project Manager
Hilary ArdenHead of
Service Delivery
Tim Jones Commissioning
Advisor
Mayrine FraserService Development
Project Manager
Debbie StoneService Development
Project Manager
Fiona GardnerOperation Projects
Officer
Henry MaceProfessional
Development Lead
Jo SayerService Development
Project Manager
FLS Implementation – A National Approach
Thursday 21st January 2016
Claire SevergniniCEO