This section sets out how to translate your agreed service model, objectives and service specification into a compelling funding proposal.
The proposal should align with local priorities, use robust evidence and demonstrate clinical, operational and financial value.
1. Understand the funding landscape
Each health system has its own structures, templates and approval routes for investment decisions. Take time to understand:
Local financial priorities and pressures
Who the key decision makers are
Required documentation and approval timelines
Consider a phased approach only where it remains clinically safe, operationally viable and supported by clear criteria for expansion.
2. Draw up a business case
Your business case should set out:
The problem you are addressing
The case for change
Your proposed FLS model and objectives
Expected benefits for patients and the wider system
Resource requirements (workforce, diagnostics, IT and operational support)
Strategic fit
Appraisal of options
Financial and workforce assumptions
Risks and mitigations
Implementation place
Include all options, including the option of doing nothing, and clearly highlight the consequences for patient outcomes and system costs.
Your local system will have its own business case template — and it is best to use this. The ROS Business Case resource is designed to help you quickly drop evidence and information into your local format.
The ROS can also share examples of successful business cases and connect you with peers who have secured funding, helping you learn from their approaches and strengthen your proposal.
3. Use evidence and tools to support your proposal
Cost benefit calculations
The ROS can provide cost benefit calculations predicting the benefits of a fully resourced FLS over five years, including:
Bed days saved
Fractures prevented
Associated cost savings
The calculator also predicts the resources and staffing your service will require, based on the population you serve.
Additional tools and evidence
Strengthen your case further by using:
Local fracture and pathway data
Workforce and capacity modelling through the ROS staffing table tool
National research from the Evidence for FLS resource
Alignment to the ROS Clinical Standards for FLS
Together, these sources will help create a robust, locally relevant proposal aligned with recognised standards and audit measures.
4. Engage colleagues who support delivery
As you develop your business case, engage early with:
IT teams — to confirm system requirements and data flows
Data, audit and information teams — to support activity modelling and validate assumptions
Operational and finance leads — to check feasibility, costs and implementation considerations
Early involvement helps avoid delays and ensures your proposal is deliverable.
5. Raising the profile of your case
Alongside this toolkit, the ROS provides free support for NHS teams developing or improving an FLS, from strengthening a business case to interpreting outcomes data and evaluating service performance.
The ROS can also highlight service gaps directly with health system leaders and use our national and local voice to champion the importance and impact of high quality FLS provision. This advocacy strengthens your local case for change and ensures it aligns with wider system priorities.
Outcomes from this stage
By the end of this stage, you should have:
A clear understanding of the local funding environment
A completed business case aligned to local templates
Evidence based resource and capacity estimates
Feasible phasing options, if required
Engagement and support from key system decision makers
