Standards and guidance

This section gives you easy access to range of guidance produced by the National Osteoporosis Society and other organisations including NICE, SIGN, the Department of Health and NOGG. 

National Osteoporosis Society guidance

The FLS Clinical Standards and Competency Framework

  • The FLS Clinical Standards provide the core standards that every FLS should meet to ensure that correct identification, investigation, information, intervention and integration with Primary Care are achieved, within a framework of quality, to the long-term benefit of fracture patients - the 5IQ approach
  • By adopting these standards, evidence-based best practice can be replicated effectively across the UK to reduce the burden of fractures while improving outcomes for patients and ensuring appropriate use of NHS resources

Guidelines for the provision of a clinical bone densitometry service

  • This guidance has been produced to support the development, implementation and operation of high-quality bone densitometry services

Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management

  • This guideline was developed by a group of clinicians and scientists with expertise in vitamin D and osteoporosis. This is a clinical guideline intended to inform patient management

A practical guide to bone densitometry in children

  • This document provides practical advice about the use of bone densitometry in children. It was developed jointly by the Bone Densitometry Forum of the National Osteoporosis Society and the British Paediatric and Adolescent Bone Group to guide healthcare professionals in the acquisition and interpretation of these measurements.

Quality Standards for Osteoporosis and Prevention of Fragility Fractures

  • Derived from current guidance, these seven standards reflect high-quality practice across the fracture prevention pathway. Detailed criteria and measures are included to allow evaluation of service performance. They provide the foundation for Peer Review of osteoporosis services

Vertebral Fractures Guidance

  • Identifying vertebral fractures systematically has proven challenging for all clinicians and currently more than two-thirds of vertebral fractures are undiagnosed. The purpose of this guidance is to ensure that all vertebral fractures are systematically identified, reported using clear terminology to the referring clinician and lead to appropriate management to avoid further fragility fractures

For more information and to download any of our standards and guidance, visit our health professionals' Tools and Resources page. 

External guidance and resources

NICE Guidance on Osteoporosis

  • Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for treating osteoporotic vertebral compression fractures. Technology appraisal guidance [TA279] Published date: 24 April 2013 
  • Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women Technology appraisal guidance [TA161] Published date: 27 October 2008 
  • Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women Technology appraisal guidance [TA160] Published date: 27 October 2008 
  • TA160 and TA161 have been partially updated by GID-TAG462
  • Osteoporosis (prevention) - bisphosphonates (inc part rev TA160, TA161) [ID782] In development [GID-TAG462] Expected publication date: TBC 
  • Denosumab for the prevention of osteoporotic fractures in postmenopausal women Technology appraisal guidance [TA204] 
  • Osteoporosis Quality Standard [QS149]
  • Public health guideline: Vitamin D: increasing supplement use in at-risk groups [PH65] (updated May 2017) (updated in May 2017 after publication of The SACN vitamin D and health report 2016)


  • SIGN 142: Management of osteoporosis and the prevention of fragility fractures 
  • SIGN 111: Management of hip fracture in older people


  • NOGG 2017: Clinical guideline for the prevention and treatment of osteoporosis 

Department of Health

NICE Quality Standard Hip fracture in adults [QA16] (published in 2012, updated in 2107)

  • A Best Practice Tariff (BPF) is a national price that is designed to incentivise high quality and cost-effective care. The aim is to reduce unexplained variation in clinical quality and to encourage best practice. The price differential between best practice and usual care is calculated to ensure that the expected costs of undertaking best practice are reflected and to create an incentive for providers to shift from usual care to best practice.
  • Additional Information: Best Practice Tariff proposals, NHSE, 2016

Supporting routine frailty identification and frailty through the GP Contract 2017/2018

  • This guidance provides GPs and Primary Care with a summary of the core contract requirements in relation to frailty within the contract and includes signposting to further support.

More information for you and your patients

Visit the Tools & Resources page to download all NOS clinical guidelines. 

Tools & Resources

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