Fracture Liaison Service Database 2020 annual report

The FLS Database Annual report 2020 provides the third national benchmark for the performance of FLSs at the patient level and shows that there has been an improvement in most key performance indicators (KPIs) but further work is needed for effective and efficient service delivery.

Key recommendations

  • Given the known low persistence to anti-osteoporosis therapies, FLSs must urgently engage with their local primary care providers to develop improved pathways to improve monitoring, with documentation that captures the importance of treatment adherence in this vulnerable patient group.
  • All FLSs should aim to detail the steps required to achieve identification of patients and submission of patient data onto the FLS-DB to 80% of expected case load for 2020/2021. This will require FLSs to define enhanced pathways for identification of fracture patients including those with spine fractures.
  • Despite the increased volume of patients seen, the proportion assessed by FLSs or receiving a dual-energy X-ray absorptiometry scan (DXA) within 90 days has remained relatively stable. With an expected increase in cases FLSs should regularly review their capacity in order to maintain standards of time to assessment, including DXA scans and monitoring.
  • Maintaining effective delivery by an FLS is challenging. Time and support for Quality Improvement should be routinely embedded into the service specification of all FLSs to drive delivery of effective patient care.

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