clinical director - nos.org.uk · 3 advert clinical director remuneration – circa £85k+ per...

Clinical Director Application pack

June 2018

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CONTENTS PAGE

Page

1. Advert 3

2. Job Description 4

Person Specification 6

Clinical Directorate Chart 7 Executive Team Chart 8

3. Our Strategic Direction

4 Forward View 2018-2020

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ADVERT

Clinical Director

Remuneration – Circa £85k+ per annum (negotiable) plus benefits including pension, life

assurance, holidays and an employee assistant programme

Location – The role is based in the charity’s offices, Camerton, Bath. The post holder is required to travel to attend relevant events and meetings across the UK, work occasional unsociable hours and be able to accommodate occasional overnight stays

Contract – Permanent, full time

The National Osteoporosis Society (NOS) is the only UK wide charity committed to ending the pain and suffering caused by osteoporosis and broken bones – and we are changing apace.

Is your vision a future without osteoporosis? Are you passionate about secondary fracture

prevention and improving the lives of people with osteoporosis or poor bone health? Would you like to make a tangible difference to health service provision – both in terms of equity and quality?

Reporting directly to the Chief Executive and as a member of the Executive Team, this position

leads the management and functions of the Clinical Directorate.

The primary purpose of the role is to ensure the clinical perspective is well understood and represented both internally and externally. This role has a broad remit combining responsibilities for influencing and networking activities, developing collaborative working

partnerships and advising the CEO on all clinical matters. Other responsibilities include clinical governance, specialist nurse services and leadership and development of the research and cure

work programmes. Applicants need to be a nurse with a current NMC registration, have a strong and proven track

record in operational delivery as well as working at a senior and strategic level to support service development, collaboration and partnerships. This position covers a wide range of

activities from research, training and development, helpline support and advice, information and publications, clinical governance and safeguarding. Consequently, the successful applicant will have a broad CV demonstrating an ability to lead and manage across such a wide-ranging

portfolio. The charity prides itself on employing highly engaged, motivated and personable individuals and it is important that applicants are able to demonstrate an ability to connect with

a diverse range of people showing presence and leadership, empathy and understanding. To apply, applicants should provide a comprehensive CV including details of relevant experience

and achievements. This should be supplemented by a supporting statement demonstrating how your skills and experience meet the person specification.

Closing Date: 10:00, Monday 25 June 2018

Assessments: Thursday 5 July 2018 at the charity’s offices, Camerton, Bath

Formal Interviews: Friday 20 July 2018 in a central London location

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JOB DESCRIPTION

Clinical Director

The Role

Reporting directly to the Chief Executive and as a member of the Executive Team, this position

leads the management and functions of the Clinical Directorate. See attached organisational chart.

The primary purpose of the role is to ensure the clinical perspective is well understood and represented both internally and externally. This role has a broad remit combining

responsibilities for influencing and networking activities, developing collaborative working partnerships and advising the CEO on all clinical matters. Operationally the directorate is responsible for assuring all clinical practice including support, information, training and

publications. Other responsibilities include clinical governance, specialist nurse services and leadership and development of the research and cure work programmes.

Leadership and Influencing

• To be the lead internal champion of the clinical aspects of the work of the charity

• Stewardship of the Clinical and Scientific community, including the Clinical Fellows, Clinical and scientific Committee members and advisers to the charity

• Undertaking an Ambassadorial role providing clinical presence at charity functions

including, fundraising and major donor events • Accountability for all the clinically focussed practice of the health professionals who are

employed by the charity • Synthesis and analysis of evidence which challenges current ways of working and

supports new approaches to practice

• Influencing key organisations which include NHS England, PHE, NICE, MSK charities and professional organisations

• Developing an annual public affairs engagement programme to raise the charity’s profile • Develop and plan the parliamentary activity of the charity and influencing strategies

across the four governments and assemblies of the UK

• Lead on the development and implementation of the patient and public involvement and engagement strategy for the charity

• Provide expert clinical leadership on all potential PR and media issues • Provide expert clinical advice for fundraising cases for support

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Governance and Assurance

• Accountability for all clinical information provided by the charity • Responsibility for all consultation responses with key UK health bodies and organisations

• Lead the established programme of quality improvement and updating of all clinical guidance and documentation. Lead the process for developing any new guidance required ensuring engagement of all relevant clinical stakeholders

• Accountability for the assurance of all clinical material contained within training and education programmes and materials

• Be the designated safeguarding lead for the charity and hold accountability for all safeguarding concerns and action.

• Provide expert clinical advice on all complaints, serious incidents or data protection issues

• Accountability for identifying and managing all clinical risks • Provide expert clinical advice to the on clinical and scientific, corporate and

pharmaceutical partnerships matters • Accountability for the Clinical and Scientific conference and clinical update events

Cure and Research

• Develop and implement the work programme associated with the Cure aim of the

charity’s strategic direction • Lead the charity’s research function including the management of Research Grants

General Responsibilities/Duties

• Leadership of the Clinical Directorate, supporting the managers in the delivery of the work

programmes and the wider contribution to the delivery of the charity’s objectives

• Responsibility for the management and development of the specialist nurse helpline function in line with the strategic direction of the charity

• Work closely with the Service Delivery Director to establish priorities and ensure the clinical needs of service delivery are met

• Lead the establishment and achievement of the clinical directorate work plans directed by

the charity’s strategic direction • Establish and control directorate income and expenditure budget

• Ensure monitoring and evaluation of outcome measures and impact is embedded in the Directorate’s work programmes as appropriate

• Deputise for either the CEO or Executive colleagues in their absence

• Participate in employee and volunteer communication and events as appropriate

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Person Specification

Essential

1. Degree level or equivalent related professional qualification 2. Nurse background with current NMC revalidation

3. DBS disclosure 4. Experience in health, education, research or government sectors

5. Management responsibility for people 6. Good project management skills 7. Ability to organise and lead complex areas of work with multidisciplinary teams

8. Has experience of providing services (including excellent customer care) 9. Strong financial management

10.Experienced senior manager 11.Excellent communication and presentation skills 12.Management and implementation of change skills

13.Innovative/creative thinker

Desirable

1. Knowledge of osteoporosis or the ability to quickly acquire this 2. Experience of working in charitable sector

The charity operates an Equal Opportunities Policy and does not discriminate on the grounds of

disability, age, ethnicity, religion, sexuality or gender.

National Osteoporosis Society Our Strategic Direction

January 2018

1. Our new strategy

More than three million people in the UK are estimated to have osteoporosis. The impact on people’s lives is huge. It has been calculated that every minute, someone in the UK suffers a broken bone through a fragility fracture.

As the only UK charity dedicated to ending the pain and suffering caused by osteoporosis, the National Osteoporosis Society has been making a real difference to people living with osteoporosis for more than 30 years. This, our new strategy, seeks to build on the work we’ve done so far.

At the heart of this strategy is evidence: research and insights gathered over several years with the help of those living with osteoporosis, health care professionals, researchers, and our inspirational volunteers and staff. Thousands of people with osteoporosis have told us about their needs and aspirations, including their priorities for the charity.

This evidence confirmed the value of our existing activities. We need to continue our work in providing excellent support services to people living with osteoporosis. And we must keep working with the NHS and healthcare professionals to ensure that quality services are available to all those who need them.

But the evidence also made it clear that people want us to stop the pain and suffering for future generations. They want us to get the message out about bone health. And they want us to do more to support the development of new treatments that may one day provide a cure.

Having reviewed all the evidence, we are now ready to restate our vision and our values and share the strategy that helps us deliver a future without osteoporosis.

Osteoporosis is a condition in which bones lose their strength and are more likely to break.

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National Osteoporosis Society | Our strategic direction

Our vision A future without osteoporosis

Our mission We will:c Improve the bone health of our nation and prevent osteoporosis

c Influence healthcare providers and professionals to deliver high quality healthcare so that people are assessed and treated for osteoporosis earlier

c Provide the best information, support and services to help people with osteoporosis live well

c Drive the research and development of new treatments and therapies that will ultimately beat osteoporosis

Our values We are:c Caring – we put your bone health and wellbeing first

c Influential – we persuade others to take positive action on bone health

c Innovative – we are bold, curious and brave about bone health

2. Our mission, vision and values

3. The principles behind our work

All our work is underpinned by three key working principles:

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Listening and advocating

Partnerships and collaboration

Evidence and understanding

We keep the voice of people affected by osteoporosis at the heart of our organisation and bring their voice to bear in all our activities

While maintaining our strong identity and purpose, we work in partnership and collaborate with others, wherever this enables us to increase our impact

We take an evidence-based approach to all our work, ensuring we have a high level of understanding of patient needs, clinical expertise and research evidence to design our activities

According to a survey by the National Osteoporosis

Society, a fifth of women who have broken a bone...

...break 3 or more before their osteoporosis is diagnosed.

4. Osteoporosis: the challenge we face

Osteoporosis is often referred to as ‘the silent condition’, in that it is silent until a bone breaks. Even then, it is not always quickly diagnosed.

A broken hip can dramatically reduce independence and can even lead to premature death.

Breaking a bone usually means significant short-term pain and inconvenience. But it doesn’t stop there. Many people with osteoporosis who break a bone live with long-term pain and disability, especially if their back is affected. The reality of broken bones and the fear of falling impacts on everyday activity, stopping people from doing the things they love.

1 in 2 have given up sport or reduced activity

1 in 3 people who have long term pain describe it as unbearable

1 in 4 people die within a year of a hip fracture

A year after a hip fracture,

80% of people need help with activities like shopping and personal care

54% of people experience height loss or a change in their body shape

Spinal fractures frequently lead to height loss and spine curvature, which leaves many people feeling self-conscious and old before their time.

33% of people who have broken a bone see friends and relatives less

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Reduced independence

Impact on health Everyday challenges

Lifestyle change

We can do things to helpWe make a significant contribution to improving the quality of healthcare and treatment that people with osteoporosis receive, which in turn helps prevent further fractures. By supporting people with osteoporosis directly, we make sure they know what they can do to improve their own bone health.

However, to achieve our vision – a future without osteoporosis – we now need to work to improve everyone’s bone health. We all need to know and talk about the things we can do to strengthen our bones; to maximise our peak bone mass and to minimise age-related bone loss. This way we can prevent many future cases of osteoporosis, and by working with researchers we can help develop the new treatments that one day will provide a cure for osteoporosis.

* For the story behind the statistic, visit www.nos.org.uk or please get in touch

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1 in 4 people who were working at diagnosis had to give up work, change their job or reduce their work

30% find osteoporosis a financial burden

Broken bones, or the fear of breaking a bone, can lead to people giving up work long before they had planned. This in turn can add to feelings of social isolation and depression, as well as to financial hardship.

49% of people who have broken a bone had their physical intimacy affected. Relationships between loved ones become strained as people become more dependent on those around them. But at the same time, many people feel unable to hug the people they love for fear of breaking more bones.

49%

It’s not just the personal cost of osteoporosis. Osteoporosis costs the NHS and social care a huge amount of money each year.

Hip fractures alone cost the NHS

£1.1 billion per year

On top of that, there are the costs of all the other unnecessary broken bones caused by osteoporosis, plus the costs of social care for those who have been so disabled by the condition that they can no longer live independently.

Personal Cost to society

Health economy

PreventionEveryone has the best possible bone health throughout their life Loss of bone strength and the associated pain and disability that fractures cause is preventable in many cases. There is much that people can do to look after their bones at all ages, particularly around nutrition and physical activity. We want to maximise peak bone mass in children and prevent premature bone loss in adults, where possible preventing people from developing osteoporosis. We want to work with other organisations to promote bone health and encourage everyone to look after their bones.

CareEveryone who breaks a bone or is at risk of osteoporosis is assessed and managed appropriately Many symptoms and poor outcomes can be prevented with effective treatment and care. We continue to work towards ensuring that everyone with osteoporosis receives the good quality healthcare they need to live life well. By making services more accessible to those who need them and by improving the quality of those services, we will further decrease the number of fractures and premature deaths while reducing costs for the NHS and social care.

5. Our strategic aims

This means:

c Influencing and collaborating with national and local policy makers to make the prevention of osteoporosis a priority.

c Developing clear, simple and evidence-based messages on how to achieve good bone health, working with other organisations to communicate these effectively.

c Supporting people and motivating people of all ages to take proactive steps to achieve good bone health.

This means:

c Driving accurate and timely diagnosis and treatment by informing and educating healthcare professionals.

c Ensuring organisations commission, design and deliver high quality services to prevent falls and fractures, providing support where needed to achieve this.

c Supporting and influencing healthcare organisations to ensure services are provided in all areas of the UK.

“ Prevention gets us talking to the next generations. Getting the message out about strengthening bones and encouraging behaviour change.”

“ Care continues our work with service providers and healthcare professionals, to improve access to good quality treatment and services for osteoporosis.”

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We understand the challenges … we’ve declared our mission, values and the principles behind our work … we’re now ready to state our strategic aims to achieve our vision of a future without osteoporosis.

SupportEveryone with osteoporosis lives well and manages their condition in ways that best meet their needs Having osteoporosis can mean living with a physical and emotional burden, and sometimes unbearable pain. Many people with the condition feel alone, afraid and helpless. We want everyone with osteoporosis to know that they can contact us for support and information that they can trust. We seek to provide a support network, connecting people to experts, local groups and a wider community of peer support, to reduce isolation and improve wellbeing.

CurePeople have fewer fractures and live well because of new interventions The development of more effective and safe treatments and therapies to prevent broken bones and improve the quality of life for people with osteoporosis is vital to our long-term vision.

We will work with other organisations to identify the research gaps and be clear on priorities. Then we can influence and steer the research agenda, encouraging collaboration and developing osteoporosis academics, to maximise the impact of new research.

We believe that new insight and development will, over time, lead to improved outcomes for people with the symptoms of osteoporosis, and ultimately, to a day when we can talk with confidence about a future without osteoporosis.

This means: c Helping people to understand osteoporosis, medication and

lifestyle choices by providing information at the right time and in the right way.

c Providing a range of accessible one-to-one and peer support services for those with osteoporosis, personalised to meet individual needs.

c Working with other organisations to ensure people with osteoporosis have access to interventions to enable them to live well and feel supported and motivated to manage their condition.

This means:c Collaborating with leading bone health researchers, industry,

government and other charities to identify priorities and coordinate effort.

c Continuously learning from research and exploring new techniques to drive forward the development of new treatments and medical interventions.

c Acting as the voice of people with the condition to make sure that their priorities and concerns are central to the research process.

“ Support is the way we help people to live well with the condition, providing information, advice and a listening ear.”

“ Cure strengthens our involvement in research, leading and coordinating effort to bring forward the day when we have a future without osteoporosis.”

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6. Our strategy at a glance

Our vision: A future without osteoporosis

Support CureCarePrevention

Everyone has the best possible bone health throughout their life

Everyone with osteoporosis is able to live well and manage their condition in ways that best meet their needs

Everyone who breaks a bone or is at risk of osteoporosis is assessed and managed appropriately

People have fewer fractures and live well as a result of new interventions

Promoting bone health, encouraging behaviour change

Providing support and information directly to people living with osteoporosis

Working with service providers and healthcare professionals to improve access to quality services

Influence and partner with organisations to develop more effective interventions and ultimately a cure

Aim

Act

ivit

y

To achieve our aims, our work is underpinned by our principles:

Listening and advocating

Partnerships and collaboration

Evidence and understanding

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OUR AIMS

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Summary

Few people are aware of the need to strengthen their bones to protect themselves for the future – and only a minority understand the harm caused by osteoporosis. Through our new strategy we will change this. We are excited about the future and we embrace the changes that the coming years will bring.

We want the nation to look after its bones, appreciate the importance of bone health for everybody and for those who do develop osteoporosis – we will be there to help them live well.

If you would like to discuss any aspect of our strategy and how you can help us deliver our vision of a future without osteoporosis, then do please give us a phone call, email or contact us via the website – we’d love to hear from you.

mailto:info%40nos.org.uk?subject=

Forward view 2018-2020 Page 1 of 24

Forward View 2018 - 2020

Contents

Background ....................................................................................................... 2

Theory of Change .............................................................................................. 3

Business Planning .............................................................................................. 4

Overview of the Charity’s Strategic Direction and Planned Activities 2018 – 2020. ..... 5

Prevention ........................................................................................................ 6

Prevention – 3 year plan ..................................................................................... 8

Prevention – Theory of Change Map ..................................................................... 9

Care ............................................................................................................... 10

Care – 3 year plan ........................................................................................... 12

Care – Theory of Change Map ............................................................................ 13

Support .......................................................................................................... 14

Support – 3 year plan ....................................................................................... 16

Support – Theory of Change Map ....................................................................... 17

Cure ............................................................................................................... 18

Cure – 3 year plan ........................................................................................... 20

Cure – Theory of Change Map ........................................................................... 21

Corporate ....................................................................................................... 22

Corporate – 3 year plan .................................................................................... 23


Background

As the only UK charity dedicated to ending the pain and suffering caused by

osteoporosis, the National Osteoporosis Society has been making a real difference to

people living with the condition for more than 30 years. We have built up a strong

reputation and we are recognised by clinicians, researchers and providers for our track

record in improving the identification, care and treatment of osteoporosis. Meanwhile,

our information and support services for people living with osteoporosis are relied on

by many thousands of people every year.

We felt that our 30th anniversary was a good point at which to take time to reconsider

our role and potential, to ensure that we continue to maximise the impact of our work

over the next 30 years.

We therefore embarked on a Strategic Review, an extensive engagement exercise with

a wide variety of people, to build our understanding of our purpose and what our

priorities should be. We listened to people living with osteoporosis, to healthcare

professionals, to researchers, to our volunteers and to our staff. We approached

people who already knew about us (such as members, and clinicians and scientists

working with us on our advisory committees) and people who had not come across us

before.

This evidence confirmed the value of our existing activities. We must continue our

traditional work of providing excellent support services to people living with

osteoporosis, and of working with the NHS and healthcare professionals so quality

services are available to all those who need them.

But the evidence also made it clear that people want us to work towards stopping the

pain and suffering for future generations. They want us to talk about the importance

of bone health to everyone throughout their lives. They also want us to do more to

support the development of new treatments and therapies that may one day provide a

cure to osteoporosis.

We have now built all this learning into our new Strategic Direction. For the first

time, this recognises the strategic importance of our work in the primary prevention

of osteoporosis, aimed at preventing people from developing osteoporosis, and of our

support to research and development in pursuance of a cure for osteoporosis,

alongside our strategic aims of improving the care available for the condition and the

provision of support to those living with osteoporosis.

This Forward View explains in more detail how we will deliver this strategy over the

next three years.


Theory of Change

The strategic direction describes what the Charity wants to achieve long term. In

order to determine how we translate these long term goals into activities for the short

to medium term, we have used the Theory of Change.

The Theory of Change is a tool to ensure that we are effective, to ensure that the

work we do really does create the impact we want to see. It is a way of ensuring that

the activities we undertake are the right ones to enable us to reach our goals. For

example, if we want people with osteoporosis to feel supported and informed about

how to manage the condition, it might seem obvious that we should provide

information and support. Over the summer, we undertook an exercise facilitated by

New Philanthropy Capital (NPC) to create a Theory of Change for each of our

strategic areas; Prevention, Care, Support and Cure.

Through the process of creating the Theory of Change, we took time to understand

and define the ultimate aim of each goal of our strategy. We then worked out what

the stepping stones would be on the way to delivering that goal – the interim

outcomes we would expect to see as we work towards that ultimate goal. We then

considered whether our existing activities were clearly aligned to those interim

outcomes (which they were), and what new areas of activity could be developed to

achieve more of those outcomes.

To link an activity to the desired effect, we need evidence. For example, is there

evidence that providing information in particular formats actually increases people’s

knowledge and understanding? Some evidence may be available in the form of

research, or in evaluations of similar work undertaken elsewhere. If there is evidence

that an approach has not worked elsewhere, we will question whether we should be

doing it ourselves. In the absence of any evidence either way, we may still feel it is

worth testing an activity to see if it works.

Whether or not there is evidence to support our approach, we should be monitoring

our work to see if it is indeed having the effect we expect. This means we need to

focus on developing ways of measuring the outcomes we expect to see. We need to

work out what indicators are relevant for each outcome. For example, if we want

people to feel informed as a result of the information we offer via patient education

events, we could ask them whether they agree with the statement that they feel more

informed as a result of attending a particular event. High levels of agreement would

indicate that the event has been effective.

The Theories of Change we developed have been summarised as ‘maps’ – graphical

representations of our aims, outcomes and activities – and are included in this

document.


Business Planning

As part of our Strategic Review, we also considered how we manage our work programmes and monitor our progress. We saw an opportunity to continue to improve the way that we undertake business planning strengthening key elements including:

• Earlier identification of projects to improve sustainability for income generation

• A more systematic approach to gathering and reviewing a range of sources of evidence to inform business plans

• A clearer process for prioritisation

• Planning explicitly linked to performance management

• Improved interdepartmental team working.

We set up five Business Planning Groups (BGPs), one each for Prevention, Care,

Support and Cure, plus one for Corporate.

The Corporate group considers the capacity, effectiveness and efficiency of the

infrastructure which supports and enables our work in all strategic areas, such as IT,

communications, fundraising, HR and accounts.

Each group has a cross section of staff from across the organisation, and meets

quarterly (or more frequently if required).

The diagram outlines the key elements in the business planning process.

The following sections provide an overview of the activities planned for 2018 – 2010 for each of the Charity’s goals.


Overview of the Charity’s Strategic Direction and Planned Activities 2018 – 2020.

Our Business Planning Group Activities 2018-2020

Prevention

• Establish a Vitamin

D national working party to develop consistent messages

for the public and health professionals

• Develop effective messaging and tools

to encourage behaviour change to improve bone

health

• Raise awareness of bone health through targeted campaigns

• Embed prevention

in our Care and Support workstreams

Care

• Work with the NHS to

increase the number and quality of Fracture Liaison

Services in the UK

• Deliver training and development for health professionals to

improve practice and strengthen clinical leadership

• Develop and

implement guidance for the identification and management of

vertebral fractures

• Scope and develop our work in the area of falls prevention

Support

• Develop our local

support services to ensure equitable provision

• Use technology to

enhance our central information and support services

• Continue to provide

high quality written information in print and online

• Produce guidance and

materials to support safe and effective exercise

• Engage people in

service improvement

Our vision: A future without osteoporosis

Our Strategic Goals

Cure

• Continue to fund

research via our research grants programme

• Review global

research and development to identify gaps and

opportunities

• Develop partnerships and patient involvement to

enable collaborative approaches to research

• Scope the potential

development of new ways to measure bone strength

Corporate

• Implement the new

brand through targeted engagement with all stakeholders

• Develop our digital

capability to increase the effectiveness of all

strategic goals

• Grow our income, focusing on the development of new

income streams

• Maintain an effective workforce of engaged and

skilled staff

• Continue to drive efficiency in all work

Prevention


Care

Everyone who breaks a bone or is at risk of

osteoporosis is assessed

and managed

appropriately

Support

Everyone with osteoporosis is able to live well and manage

their condition in ways that best meet their

needs

Cure

People have fewer fractures and live well

as a result of new

interventions

Corporate

The organisation operates efficiently

and effectively


Prevention


Loss of bone strength and the associated pain and disability that broken

bones cause can be prevented in many cases. There is much that people can

do to look after their bones and muscles at all ages, particularly around

nutrition and exercise.

We want to maximise peak bone mass in children and prevent premature

bone loss in adults, where possible preventing people from developing

osteoporosis. We want to promote active ageing and prevent frailty,

supporting those in later life to maintain muscle strength and a healthy

lifestyle in order to have strong bones.

A new strategic priority

Whilst this is not a completely new area of work for us, we have made primary

prevention a strategic priority. This area of work is targeted at preventing people

from developing osteoporosis. Research has shown that healthy lifestyles enable

people to maximise their bone strength and peak bone mass (which generally occurs

at around age 30), and to reduce age-related bone mass loss thereafter. Certain

groups of people are at an increased risk of developing osteoporosis. These include:

• People with other conditions that are associated with an increased risk, including coeliac and Crohn’s disease, and eating disorders such as anorexia

• People on medications which have been linked to bone loss, such as aromatase inhibitors (commonly used in the treatment of breast cancer), and steroids

• People with a family history of osteoporosis.

Whilst recognising that many in the high risk groups will go on to develop

osteoporosis, preventative action may delay onset and reduce the severity of disease.

Ensuring we make a real impact

We will define the potential audiences that we will target through our prevention work

to ensure that we spend our funds in ways which will create the most impact in terms

of preventing future cases of osteoporosis. To aid prioritisation we will conduct a

scoping exercise to review the scientific evidence to identify the audiences most likely

to benefit from interventions or activities aimed at improving bone health. The scoping

exercise will underpin the Charity’s prevention work plan.


Focusing on exercise and nutrition

Many of the steps that people can take to help prevent osteoporosis from developing

are common healthy lifestyle factors that are already promoted to prevent other conditions such as cancer, heart attack, diabetes etc. These include avoiding smoking

and the excessive consumption of alcohol, maintaining a healthy weight, and keeping active. If we were to focus our efforts on these messages, it is unlikely that we would

have much impact in reducing the incidence of osteoporosis. We will recognise these lifestyle factors in the messages we put out and will also work with other organisations

such as Public Health England to include bone health messages in their communications

We have recognised that there are two areas where the Charity can provide take a

major role in improving lifestyle to prevent osteoporosis – these are

• adequate levels of Vitamin D (through both diet and exposure to sunlight)

• a healthy diet containing sufficient calcium and vitamin D

• participating in exercises that build and maintain strong bones (weight bearing

and muscle strengthening).

These areas will be central to our prevention work plan. The output of the scoping

exercise will determine what specific action the Charity should take in these areas.

Vitamin D

There is a lack of consensus and clear guidance for the public and health professionals

on adequate uptake of Vitamin D. The first step to getting out strong messages with

respect to Vitamin D is to build a consensus among organisations providing advice on

what the recommended levels of Vitamin D should be. The Charity recently held a

meeting of key stakeholders to begin this task. The output from this work will be

taken forward and updated guidelines for healthcare professionals, the public and

those at high risk of vitamin D deficiency will be developed.

Raising awareness of the importance of bone health

A key focus of the prevention work is to raise awareness of bone health among the

public and healthcare professionals. We aim to do this by

• Campaigning to increase engagement with the bone health agenda, and raise

awareness of osteoporosis and the Charity.

• Working with other organisations, including government bodies and other

charities, to ensure they include bone health messages in their communications

and where appropriate they take action to improve bone health.

• Embed prevention messages in both Care and Support, using a recognised

method (‘Make Every Contact Count’) to ensure we take every opportunity to

explain our prevention messages to the wider family and social networks.

• Explore the potential to work with other organisations on the use of tools to

support behaviour change e.g. digital tools such as apps.


Prevention – 3 year plan

Objective Activity Targets 2018 2019 2020

Develop strategy to improve

primary prevention of osteoporosis

Undertake scoping exercise to identify key

partners and appraise options

Work plan and business cases

developed

Implement plans and embed new work

✓

✓

✓

Ensure clear and

consistent guidance is

available for Vitamin D

Develop a national

consensus position on Vitamin D and promote

Produce guidance for

health professionals

Produce guidance for

the public and those at high risk

✓

✓

Increase awareness of the

importance of bone health

Develop and promote a range of targeted bone

health messages, in partnership with other organisations

Develop and agree messages

Run awareness raising campaigns

Work with others to

include our messages in their communications

Embed prevention messages throughout our work in Care and

Support

✓ ✓ ✓

✓

✓ ✓

✓ ✓

Improve bone health

Influence national strategy through our parliamentary work, and

working with Public Health England and the NHS

Explore the potential to work with other

organisations to develop tools to support behaviour change

Build relationships and engage

Ongoing

stewardships and engagement

Identify potential

partners

Scope potential development

Collaborate to develop new tools

✓

✓

✓

✓

✓

✓


Prevention – Theory of Change Map

Key: Enabler Activity Outcome Final goal


Care

Everyone who breaks a bone or is at risk of osteoporosis

is assessed and managed appropriately

Many symptoms and poor outcomes can be prevented with effective

treatment and care. We continue to work towards ensuring that everyone

with osteoporosis receives the good quality health care they need to live life

well.

By supporting the NHS to make services more accessible to those who need

them and by improving the quality of those services, we help to decrease the

number of fractures and premature deaths while reducing costs for the NHS

and social care.

Professional Development

One of the main objectives in achieving the Care goal is to ensure that healthcare

professionals are well trained. To this end, we will continue to run established and

develop new training and professional development programmes. Training and

professional development already planned include the following:

• Fracture Prevention Practitioner online course, foundation and advanced level

• National Training Scheme for Bone Densitometry course

• FLS workshops

• GP online training

• GP webinars

• Mellanby course

• FLS Champions’ Summits

• Clinical Updates

• Osteoporosis Conference

As a new addition, we will create and deliver a clinical leadership programme, aimed at developing the next generation of leaders in the field of osteoporosis. This will

ensure our continued ability to maintain the high profile of osteoporosis at local and national levels within government, the NHS and academia, as well as continued high

quality clinical input into the Charity’s strategic direction.

We have developed a network of Allied Health Professionals to improve the skills and

knowledge of the many professionals involved in caring for people living with

osteoporosis. Over the next year, we will be considering how best to develop clinical

networking opportunities to further this work.

Vertebral Fractures

We have been aware for some time that vertebral fractures are often not identified.

People presenting to their GP with back pain are often not assessed for vertebral

fracture, and by the time they are recognised, many people have already suffered


several vertebral fractures. This not only causes significant discomfort and symptoms

such as difficulties with breathing and eating, but also means that drug treatments to

build bone strength and avoid further fractures such as hip fractures are not being

prescribed in a timely manner.

We have therefore developed guidance on the identification of vertebral fracture, and

in 2018 we will focus on disseminating this guidance out to healthcare professionals

and developing new training to support it.

The next step will be to review the current guidance for healthcare professionals on

how to manage vertebral fractures, and to update this if needed.

In 2019, we plan to launch a consumer campaign, to raise awareness of the signs and

symptoms of vertebral fractures so that people are informed and empowered to

discuss with their GP and they are managed appropriately.

Fracture Liaison Services (FLS)

There is a strong evidence that FLSs are effective in the identification and

management of fragility fractures. We are therefore working towards ensuring that

everyone has access to an FLS service, with a target of 70 percent of the population

having such access by the end of 2020.

We will work closely with clinical leads and commissioners to build business cases to

ensure that FLS services are commissioned and sustained, and to increase the number

of services that are comprehensively commissioned.

In addition to extending the reach of FLS services, we seek to improve the quality of

FLS services. We will do this by:

• Undertaking gap analyses of each FLS against the Charity’s FLS Standards, to

identify areas for improvement and to monitor improvement over time

• Facilitating peer reviews of services, to develop and spread best practice

Falls Prevention

Whilst we are already involved in falls prevention at a national strategic level, it is

recognised that we could develop our work in this area. This is part of secondary

prevention, in that many fractures can be prevented if falls are prevented.

It is important to note that many organisations are already involved in falls

prevention, and that approaches by local authorities and CCGs vary greatly across the

UK. It is therefore difficult to determine how best to use our resources to add value to

this area. In 2018, we will undertake a scoping exercise, as a precursor to

understanding our contribution to an effective programme of work.

Information, Guidance and Standards

All our work in developing high quality care depends on the Charity having credible

clinical information, standards and guidelines which we can disseminate with

confidence. Work to review and update all this documentation is ongoing and is

fundamental to all our work in Care and Support.


Care – 3 year plan


Improve the skills and

knowledge of healthcare professionals

Provide training and networking for health

professionals

Ongoing delivery of Bone Densitometry,

Fracture Prevention and other training

Local networking and

study days

The Charity’s Osteoporosis

Conference

Clinical Leadership

programme

Develop, maintain and disseminate

clinical guidance and standards

✓ ✓ ✓

✓ ✓

✓ ✓

✓

✓ ✓ ✓

✓

Extend coverage of Fracture

Liaison Services

Support the commissioning of new

FLS services

70% of population covered by an FLS by

end 2020

✓

✓

✓

Improve the quality of Fracture Liaison

Services

Encourage FLS services to participate in peer reviews

Carry out Gap Analyses of FLS services against our standards

5 reviews per annum

Repeat reviews show

improvement in performance against standards

✓

✓

✓

✓

✓

✓

Improve the

identification and management of people with

vertebral fractures

Implement and promote

guidance for the identification of vertebral fractures in secondary

healthcare services

Develop guidance for the

management of vertebral fractures in secondary healthcare services

Develop guidance

and messages

Promote messages

Launch training

module

Review guidance

Consumer campaign

✓

✓

✓

✓

✓

✓

Define our role in

falls prevention

Review evidence and

scope potential work

Scoping exercise

Develop work plan

✓

✓


Care – Theory of Change Map



Support

Everyone with osteoporosis lives well and

manages their condition in ways that best meet their needs

Having osteoporosis can mean living with a physical and emotional burden,

and sometimes unbearable pain. Many people with the condition feel alone,

afraid and helpless.

We want everyone with osteoporosis to know that they can contact us for

support and information that they can trust. We seek to provide a support

network, connecting people to experts, local groups and a wider community

of peer support, to reduce isolation and improve wellbeing.

Specialist Nurse Helpline

The central Helpline providing information and support from specialist nurses, via

telephone, email or letter, remains a key service. It is used by thousands of people

every year. We are currently piloting whether triaging calls is an effective way of

increasing the capacity of the service. We will also be looking at whether the helpline

can be extended to offer a live chat facility via the website.

Information

The provision of information also remains a key function for the organisation. We will

continue to provide a range of leaflets and booklets and information on our website

with information about the condition, lifestyle choices and drug treatments. We will

also consider how we could make our information more accessible and engage a wider

audience.

Support Groups and Volunteers

We have a network of volunteer-led support groups across the UK. These groups

enable us to provide a face-to-face presence to a large number of people in their local

areas, with events and meetings to share information and provide peer support.

Volunteers also have a role in raising awareness of osteoporosis and the Charity, by

speaking at local events, hosting information stands e.g. at exhibitions.

We will invest in our volunteer base to drive recruitment and retention of volunteers,

developing a framework to ensure that volunteers are able to provide a quality service

on our behalf, and that volunteers find their experience with us to be fulfilling.

Information sessions for those with osteoporosis

We will continue to ensure that we provide education sessions for those individuals

with a recent diagnosis, and update sessions for those living with the condition.

Whilst many of these are organised (and indeed funded) by support groups, the

Charity will also continue to arrange these in conjunction with healthcare service

providers, particularly where no support group operates.


Options to develop peer support

We recognise that even if all major towns and cities of the UK were covered by

support groups, we would still be inaccessible to many people in rural areas, where

transport services are limited, and for people who are unable to leave their homes.

We will therefore, consider developing other ways of providing peer support, for

example through telephone befriending or a digital based solution.

Exercise

We have understood and promoted the role of weight bearing exercise in improving

bone health for many years. However, we are frequently asked, both by people living

with the condition and by healthcare and exercise professionals, what exercises can be

safely undertaken when people have bones that are at risk of fragility fracture, or who

have already suffered broken bones, especially vertebral fractures. The Charity’s

survey A Good Life with Osteoporosis (2015) confirmed this was a priority for people

with osteoporosis.

We are therefore working to develop guidance and resources to bring clarity in this

area, in collaboration with the Chartered Society of Physiotherapy. In 2018, we will

scope the exercise-based tools, products and services that will provide most benefit.

Public and Patient Involvement and Engagement (PPIE)

We have focused on improving life for people with osteoporosis throughout our 30

year history. To this end, we have made sure that we understand what people living

with the condition want and need, for example through our network of support

groups, through the Members and Volunteers Committee, and through the many

detailed research studies we have undertaken. We are now formalising this approach

in an overarching PPIE strategy and policy.

We also recognise the role of people living with osteoporosis in driving forward quality

healthcare services. We want to set expectations as to what good quality care is,

explain how to get involved in PPIE opportunities in local services, and encourage

people to raise concerns when care is poor. In this way, people with the condition can

take an active role in service development.

South Central Pilot

We are committed to ensuring that the money donated to us is well spent in creating

the maximum impact. This means we need to evaluate our current working practices

and test out other possible working methods, to see if these are more effective and

efficient. This is the purpose of the South Central Model of Support Pilot.

The pilot got underway in Q2 2017, and will continue throughout 2018, with a full

evaluation in Q1 2019. The pilot represents a new approach to work in local

communities, focusing on maximising opportunities for building local relationships with

both community groups and businesses, to raise awareness of osteoporosis, the role

of the charity, and ultimately, to raise funding to enable yet more work to be

undertaken locally. The pilot is being evaluated, and the output from the evaluation

will inform future service developments.


Support – 3 year plan


Improve the wellbeing of

people living with osteoporosis through the

provision of centralised and locality-based

information and support

Provide a central information and support

service

Provide information

materials in a variety of formats

Develop equitable access to patient education and peer support across the

UK

Continue to provide helpline

Scope additional support services using new technology

New technology support services launched & delivered

Continue to review and produce assured

information

Deliver patient education sessions

Develop peer support opportunities

✓

✓

✓

✓

✓

✓

✓

✓

✓

✓

✓

✓

✓

✓

✓

Increase participation in

exercise to improve bone strength

Develop resources for healthcare and exercise

professionals

Scope and develop options to facilitate safe

exercise

Develop resources

Consensus statement

launched

Research options

Launch training for

professionals

✓

✓

✓ ✓

✓

Improve public engagement and involvement

Develop methods of embedding the voice of people with osteoporosis

to inform our own work, improve healthcare services, and focus the

research we support

Embed Public and Patient Involvement and Engagement

(PPIE) strategy

Develop resources so that people can

shape local services

✓

✓

Increase volunteer network

Improve volunteer recruitment and retention

Develop and embed new volunteer framework

✓

✓

✓

Improve

effectiveness of regional work

Complete South Central

Model of Support pilot

Complete pilot

Evaluate

Roll out learning

✓ ✓

✓

✓

✓


Support – Theory of Change Map



Cure

People have fewer fractures and live well because of new interventions

The development of more effective and safe treatments and therapies to

prevent broken bones and to improve the quality of life for people with

osteoporosis is vital to our long-term vision.

We will work with other organisations to identify the research gaps and be

clear on priorities. Then we can influence and steer the research agenda,

encouraging collaboration and developing osteoporosis academics, to

maximise the impact of new research.

We believe that new insight will, over time, lead to improved outcomes for

people with the symptoms of osteoporosis, and ultimately, to a day when we

can talk with confidence about a future without osteoporosis.

Background

The Charity has been providing support and funding to researchers for much of the

last 30 years, through our Research Grants Programme. Over the Charity’s history we

have also contributed to developments that have significantly improved the availability

of effective treatments for people with osteoporosis. Through our Cure goal, we will

build on this work to develop a strategic approach to improving outcomes for patients,

and in the long term, to eliminating the condition.

Ending the suffering of osteoporosis is a top priority for people with the condition. They want to ensure that future generations are spared from the pain and suffering caused by osteoporosis Significant progress has been made over recent decades with

the development of a range of treatments for osteoporosis that are widely available in the UK and are proven to be cost effective. There are challenges to the available

options that necessitate the need to continue to develop new interventions. Issues include low adherence to bisphosphonates, concerns about health risks of treatment (e.g. atypical fractures) and limited options for long term treatment. Although drugs

are effective in reducing fracture risk, current interventions do not resolve symptoms resulting from previous fractures such as pain and curvature of the spine.

Ultimately a ‘cure’ would either prevent people from developing osteoporosis in the

first place or, in those with osteoporosis, would restore bone strength to ensure no

further fractures occur, and provide a complete resolution of symptoms. With this

definition, ‘cure’ can be seen to be a long-term goal, which will depend on research

and development in a wide range of areas.

While a cure is most likely to be a drug it could also be in the form of a genetic

therapy, vaccine or regenerative technology. It is entirely possible that the most beneficial intervention hasn’t been developed yet.


A strategic approach

Before we can decide how best to work towards a cure, we need to have a good

understanding of what research has been done globally to date, so that we can

identify the gaps and opportunities to prioritise new research. The work undertaken to

date has identified that developing a better measure of bone strength is a priority

however there are likely to be other crucial areas. A review of the current

osteoporosis research and development to identify gaps and prioritise research, the

output used to develop a research road map.

We acknowledge that an eventual cure will be founded on the work of many people in

different areas of scientific pursuit. Progress will require collaboration between

academics, industry and government to collectively identify research priorities and

opportunities for joint working. The Charity has a vital role to play in being an ‘honest

broker’, facilitating partnerships and driving the agenda.

Developing a cure relies on the having a skilled workforce with the capacity and

funding to undertake the relevant research. The Charity will continue to support

researchers in the field of osteoporosis and influence funders to ensure continue

progress.

Grants programme

We will continue our grant funding round every two years, with future rounds being

aligned to the research priorities that we identify in the intervening period.

Support for research

We will be developing our processes for supporting research. The main ways in which

we get asked to support research are threefold:

• to facilitate patient and public involvement and engagement (PPIE)

• to use our networks to provide expertise on steering groups and advisory

panels, and

• to disseminate findings through our publications and events.

To enable us to do more work in this area and to cover the cost of our time and our

people, we will introduce a system of charging fees for these services in 2018.

Meanwhile, to enable us to provide more options for PPIE, we will develop a full PPIE

policy, and will investigate the potential of setting up a register of people living with

osteoporosis who are willing to be contacted proactively to participate in research.

Communications

As we scope and define the Cure work stream, there is a need to develop methods of

communication to explain to stakeholders, including the scientists and clinicians that

we want to involve and influence through the creation of a research forum, and the

potential donors and funders for this work.


Cure – 3 year plan


Develop an effective strategy

to pursue the long term aim of finding a cure

Review global research and development to

identify gaps and opportunities

Develop partnerships to enable collaboration on major projects and

develop our influence to steer future research

Work in partnership to develop accepted new

methods of measuring bone strength

Scope R&D review

Undertake R&D

review to prioritise future research

Identify potential

partners

Embed forum for collaboration

Scope potential areas for development and

identify partners

Start working in collaboration on new

ways to measure bone strength

✓

✓

✓

✓

✓

✓

✓

✓

Support research identified by

academics and clinicians as likely to advance

our research strategy

Run biennial Research Grants programme

Offer support to

researchers, particularly with regard to Patient and Public Involvement

and Engagement

New awards made

Ongoing grant

management

Embed new process

for agreeing to and charging for a range of research support

services

✓ ✓

✓

✓

✓

✓ ✓

✓

Engage a wide audience in the Cure work

stream

Develop and promote messaging about the cure workstream for a

variety of audiences

Develop communications plan

Disseminate and promote messages

✓

✓

✓


Cure – Theory of Change Map



Corporate

The organisation operates effectively and efficiently

The Corporate work-stream has a broad focus, overseeing the charity’s

infrastructure, resources and processes needed to deliver our strategy.

The ability of the Charity to deliver services to beneficiaries is dependent on

making the best use of our resources and we have the processes to ensure

the Charity is run efficiently and effectively. This means employing the right

people and giving them the tools they require to do their job, generating the

income we need to delivery our plans, having good financial management

and governance.

‘Who we are and what we do’

Engaging new and existing stakeholders in our new strategic direction – who we are

and what we do – is vital. The Brand project will bring this to life in 2018 based on

the output of the brand development work undertaken in 2017.

Implementation will involve everyone across the Charity. To support the

implementation, a number of brand implementation working groups have been set up

involving staff from all teams. These groups will identity the implications of the new

brand for different audiences.

Income Innovation

We will also work with Good Innovations in early 2018, to appraise our assets and

capability and identify opportunities to create new income streams for the future. As

well as maintaining our traditional fundraising activity (and ensuring GDPR

compliance), we will be developing commercial partnerships to increase trading

income. We will remodel our retail operation, to put it on a sound financial footing.

Digital Development

We want to harness the opportunity offered by digital channels and technology to

improve all aspects of our work. Digital development is vital to all areas of the

Charity’s work. It enables us to increase engagement with different audiences,

improve our internal processes and, through the data captured, identify areas where

we can be more effective and efficient.

We have been working with Edo to define the future digital roadmap for the

organisation. In 2017, they undertook a review of digital in the Charity and identified

several priority areas for our digital development. These include development of

processes for publishing and managing content on the website, digital skills mapping,

and primary research to understand audience needs. The pathfinder projects will be

conducted in 2018. A digital strategy and roadmap for future digital developments will

be produced in 2018.


GDPR

Changes to data protection law which come into force with the General Data

Protection Regulation in 2018 mean that we need to change the way in which we

request, record and evidence consent to communicate with our supporters and

stakeholders. In December 2016, the Board of Trustees approved a proposal to move

to an opt-in model of consent across all communication channels.

The Charity has been planning for this change and in 2018 will continue the

implementation of a programme of communications to encourage existing and

potential supporters, and other stakeholders, to opt in to charity communications.

Our People

We can only deliver our strategy with an effective team of engaged employees.

Improving recruitment, induction, training and employee engagement, and acting on

the findings of the recent staff survey are key to this.

Corporate – 3 year plan


Sustain and increase income

generation from existing sources

Grow existing fundraising activity from legacies, major

donors, trusts, and community / events

Grow public and healthcare professional membership

base

Develop existing commercial activities

Year on year stretch targets in all

fundraising

Continued review and

promotion of membership

Consolidate retail

activity

Develop B2B and B2C partnerships

✓

✓ ✓

✓

✓

✓ ✓

✓

✓

✓ ✓

✓

Identify and

develop new income streams

Use assets and capabilities to

create new sources of income

Review of assets and

capabilities

Development of new commercial activities

✓

✓

✓

Increase both awareness of us and engagement

with us

Launch new brand Preparation

Engagement

Launch and promote

✓

✓

✓

✓

✓



Increase the

effectiveness of the charity

Maintain a highly skilled

workforce

Business planning

Embed evidence-led

approach to strategic development

Overhaul recruitment

and induction

Embed new process

Develop outcomes

measurements

Embed evidence reviews

✓

✓ ✓

✓

✓ ✓

✓ ✓

Increase the efficiency of the charity

Improve IT systems to improve effectiveness and efficiency

Maximise use of offices

Ensure value for money in all procurement

Make efficiency savings in all areas of work

Finance systems

HR systems

Grants admin system

Replace shared drive

Complete CRM implementation

Complete projects identified by Edo

Refurbish offices

Develop procurement system

Develop guidance and

improve working practices

✓

✓

✓

✓

✓

✓

✓

✓ ✓

✓

✓

Maintain reputation by

ensuring best practice in governance and

compliance

Ensure GDPR compliance by May 2018

Ongoing review of external environment

Opt-in for communications and

data retention periods embedded

Changes in legislation

and best practice responded to

✓

✓

✓

✓

National Osteoporosis Society Camerton, Bath, BA2 0PJ

General email: [email protected]

Website: www.nos.org.uk

Telephone: 01761 471771

Free Specialist Nurse helpline 0808 800 0035

President: HRH The Duchess of Cornwall

National Osteoporosis Society is a registered charity no. 1102712 in England and Wales and no. SC039755 in Scotland.

Registered as a company limited by guarantee in England and Wales no. 4995013

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