The Fracture Liaison Service Database (FLS-DB) is a new feasibility study looking at patterns of assessment and treatment for osteoporosis and falls across primary and secondary care

What does it measure?

The Fracture Liaison Service Database (FLS-DB) aims to answer the following questions :

  • What proportion of non-hip fragility fracture patients are assessed for (i) osteoporosis and (ii) falls risk?
  • What proportion of patients are treated for osteoporosis?
  • What proportion of patients are treated for falls risk?
  • What proportion of patients have a subsequent fracture
  • What proportion of patients comply and persist with treatment?

During the feasibility study, we will be addressing the following feasibility questions:

  • Can patients who have had a fracture be identified from GP electronic patient records?
  • Which fields within GP records are used to indicate assessment and treatment of osteoporosis and falls risk?
  • Can records for the same fracture be matched across GP and FLS databases?
  • Is it possible to estimate the total number of fractures using hospital episode statistics (A&E and outpatient databases)?


The FLS-DB aims to improve the quality of patient care by enabling NHS organisations to:

  • compare their outcomes of care with similar NHS organisations
  • identify and share best practice
  • identify gaps or shortfalls in commissioning services
  • provide a more comprehensive picture of fragility fracture care and outcomes in England.

Through participation in the audit, local services are able to benchmark their performance and identify where they are performing well, and improve the quality of treatment and care they provide. On a national level, wide participation in the audit also provides an overview of the quality of care being provided in England.

Who manages the audit?

The FLS-DB is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and delivered by the Royal College of Physicians (RCP), working with Royal College of Surgeons, Health and Social Care Information Centre (HSCIC) and National Osteoporosis Society.

What information is available for patients?

The audit steering group has produced a patient information leaflet and poster describing the purposes of the audit, governance/management arrangements, the information that will be collected, how the information will be stored and used, and what patients should do if they don’t want their details to be submitted to the audit. We recommend you make this leaflet available to patients at your hospital or practice who have suffered a fracture.

How to participate

Primary Care

View further information on how GP practices can participate

Secondary Care

Any secondary care organisation that treats fragility fractures can participate in the project providing you have:

  1. an osteoporosis service or pathway
  2. a falls service or pathway
  3. a dedicated coordinator (Fracture Liaison Nurse or equivalent) who can:
  • pick up the fragility fracture patients
  • assess them for osteoporosis and falls risk, or send them in the right direction
  • inform the GP of the situation and the action taken.

Fracture Liaison Services with their own databases can continue to use them to collect data and will be given access to a web portal for upload. Services without their own databases can gain access to a web database. For more information contact

Organisations that are unable to contribute data to FLS-DB but are looking to establish local services, can register to be involved in our Fragility Fracture Support network by emailing

Related links

National Osteoporosis Society - FLS toolkit

Last updated on: 02 September 2014

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