This section provides ideas on how to develop your FLS and maintain quality, monitor performance and embed continuous improvement to ensure people with osteoporosis get high-quality care.
1. Capture, record and evaluate data
High quality data collection is essential for demonstrating the impact of your FLS and supporting ongoing improvement and investment.
Register with the FLS-DB
Confirm current FLS-DB participation and submission requirements before launch, and assign clear responsibility for data quality, validation and timely submission.
The FLS-DB reports performance through 11 key performance indicators covering data completeness, case identification, timely assessment and DXA, falls assessment, treatment, strength and balance training, monitoring and medicine adherence.
Your service should aim to deliver these KPIs as part of routine practice.
2. Ongoing monitoring and evaluation
Build structured monitoring and evaluation processes into your service from day one. This could include:
Reviewing performance against the 11 KPIs
Identifying what is working well and what needs improvement
Using data to drive continuous quality improvement
Taking part in national audits to benchmark your performance
Regular evaluation strengthens the consistency, safety and impact of your FLS.
3. Refining your pathway and resources
Based on your evaluation findings and stakeholder feedback:
Refine your clinical pathways
Update clinical templates, documentation and patient facing resources
Adapt staffing levels, workflows or processes where needed
These changes help ensure your FLS continues to meet best practice standards and respond to patient needs.
4. Take part in formal improvement programmes
Structured improvement programmes can help embed learning and sustain high performance.
These may include international networks such as IOF-endorsed communities, national audit and improvement resources from FLS-DB, and ROS regional forums or peer-support groups.
Peer support and shared learning
Opportunities to compare approaches
Access to expert input and good practice
Participating in these groups and programmes strengthens local delivery and fosters continuous improvement.
5. Continuous improvement
Sustainability depends on regularly capturing and reviewing:
Activity levels
Patient outcomes
Staff feedback
Operational challenges
Provide a clearly labelled resources area with current links to FLS-DB guidance, audit reports and improvement tools.
6. Celebrating success
Recognising achievements is an important part of sustaining motivation and engagement.
Share examples of good practice within your organisation
Celebrate progress against KPIs
Highlight improvements in patient experience or outcomes
The ROS would also welcome hearing about your success - contact us to share your achievements, innovations or learning.
New developments and new funding
Keep evidence of activity, outcomes, unmet need and patient experience up to date so that future service-development proposals and funding bids are timely and well supported.
