National Osteoporosis SocietyPriorities and Plans for 2017Aim 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

NOS Activity – Intervention TypeEngland NI & IOM Scotland Wales UK

New Service Development

56 1 2 7 66

Quality Improvement – Commissioning

36 5 1 1 43

Quality Improvement – Peer Support

23 1 12 6 42

Early Engagement

20 0 1 2 23

Total 135 7 16 16 174

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Service Improvement - CommissioningEngland NI & IOM Scotland Wales UK

New Services 13 0 1 3 17

Existing Service Enhanced

6 0 0 0 6

Total 19 0 1 3 23

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New Services - ValueEngland Scotland Wales UK

Total population covered

4,201,867 300,410 962,188 5,464,465

Hip fractures prevented*

1,482 102 348 1,932

Gross benefit of all fractures prevented*

£29,841,500

£1,995,006

£6,772,362

£38,608,868

*Over 5 years

Figures based on 17 new service NOS has helped commissioned

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No. Standard Rationale

1 IDENTIFICATIONAll patients aged 50 years and over with a new fragility fracture or a newly reported vertebral fracture will be systematically and proactively identified.

Patients who have sustained a fracture are at higher relative risk of fracture than those who have not. Targeted interventions in this population will have most impact on reducing the future fracture burden.

FLS Clinical Standards – Standard 1

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To conduct an evaluation of provision for the systematic identification of newly reported vertebral fractures in patients aged over 50 at FLS sites across the UK.

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Objectives

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• 78 sites in the UK

• Measure of existing service vs clinical standards

• Systematic identification of vertebral fractures

• Opportunistic & Presenting search

Method

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Table of Results Country Number of

ServicesFullIdentification

PartialIdentification

NoIdentification

Wales 16 1 10 5

England and NI

46 1 7(2 intention)

36

Scotland 16 6 2 8

Totals 78 8 21 49

% 100% 10% 27% 63%

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IN SUMMARY78 Sites -GAP ANALYSIS • 10% Systematically Identifying Vertebral fractures

• 27% Partial (2 HAVE AN INTENTION TO START)

• 63% Nothing

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Steps in the right direction• NOS and Clinical Specialist collaboration

• Establish correct terminology

• Education to identify VFX indications

• Education across services e.g. radiology, primary and secondary care

• Pathway development Guidance LaunchMay 2017 roll out of guidance by the NOS through collaboratively working with service providers.