Getting Started

Establishing your case for a fracture liaison service

Establishing or improving an FLS requires a clear plan, strong leadership and engagement across the health system. This section outlines the early steps needed to build a credible, well-structured case for investment.

1. Funding feasibility

Understanding your funding environment early will help you shape a realistic and timely proposal.

Consider:

  • Which funding routes are available locally, regionally or nationally

  • Commissioning priorities within your local health system or commissioning structure

  • Key financial planning and budget cycles

  • Submission deadlines for business cases

Why this matters:

  • Clarity on feasibility allows you to build your timeline, set expectations, and ensure your proposal lands at the right moment.

2. Identify a clinical champion

A successful FLS needs clear clinical leadership. This may be you or another clinician committed to driving the project forward.

A strong clinical champion:

  • Provides expert leadership and credibility

  • Advocates for the service with colleagues and senior leaders

  • Keeps momentum through planning and approvals

Why this matters:

  • Clinical champions play a critical role in shaping the vision and maintaining engagement.

3. Secure senior buy‑in

Executive support is essential for prioritisation, resourcing and successful decisionmaking.

Actions to take:

  • Identify the appropriate executive sponsor or senior responsible owner for your health system

  • Initiate early conversations about the benefits of FLS

  • Align your case with local, regional and national priorities

  • Highlight quality improvements, safety gains and cost savings

Why this matters:

  • Senior sponsorship helps accelerate progress and reinforces organisational commitment.

4. Establish the project team

Building a strong project team ensures your business case is comprehensive, evidence based and deliverable.

Your team should include:

  • A named lead responsible for drafting the business case

  • Clinical representatives across fracture, falls and osteoporosis pathways

  • Operational and managerial colleagues

  • Administrative or project management support

  • Finance and business planning expertise

  • Data, information and IT or digital expertise

  • Primary Care

  • Patient or lived experience representation; Patient and Public Involvement and Engagement (PPIE)

Why this matters:

  • Clear roles and responsibilities will ensure smooth progress throughout development

  • Patient or lived experience presence will authentically bring to life the impact on a personal level. The patient is the purpose, and their story is important

5. Build your project plan

A structured project plan helps you stay on track and communicate progress.

Include:

  • A target submission date for the business case

  • Key milestones for drafting, consultation and approval

  • Alignment with your organisation’s financial and planning cycles

  • Key risks

  • Dependencies and governance arrangements

  • Regular review dates

Why this matters:

  • Demonstrating a clear pathway from idea to decision strengthens confidence in the proposal.

6. Create a stakeholder reference group

Engaging a broad range of voices ensures your service is grounded in real-world needs and experiences. The reference group should complement the core project team, provide structured feedback at agreed intervals and support key design decisions.

Include:

  • People with lived experience of fractures or osteoporosis

  • Clinicians working in fracture care, falls prevention and bone health

  • Operational teams involved across the pathway

  • Primary, secondary and community care partners

Why this matters:

  • Involving people with lived experience and colleagues across the fracture-prevention pathway helps identify gaps, opportunities and dependencies, and strengthens system-wide alignment.

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