Fragility Fracture Network policy toolkit

HPP supported the Fragility Fracture Network to produce policy and clinical toolkits for the FFN Global Call to Action.

Fragility Fracture Network policy toolkit


Across the world, it is estimated that at least 56 million fragility fractures occur every year. As populations are ageing, the burden of fragility fractures and their associated costs is likely to rise.

Despite this, fragility fractures are seldom seen as a political priority. Advocates of fragility fracture prevention and care have repeatedly called on governments to urgently address the human and economic toll they are placing on societies.

The Fragility Fracture Network (FFN) is a global multidisciplinary alliance whose mission is to advance treatment and secondary prevention of fragility fractures. The FFN Global Call to Action, endorsed by more than 130 organisations worldwide, was published in 2018. It sets out the four pillars of effective fragility fracture care:

  1. Multidisciplinary care of the acute fracture episode along orthogeriatric lines
  2. Excellent rehabilitation to recover function, independence and quality of life, starting immediately but continued long term
  3. Reliable secondary prevention after every fragility fracture, addressing falls risk as well as bone health
  4. Formation of multidisciplinary national alliances to promote policy change that enables the above three.

What we’ve achieved

The FFN commissioned HPP to write and produce a policy toolkit for its members. The toolkit is based on Pillar IV of the Global Call to Action, and accompanies a clinical toolkit based on the first three pillars. The FFN authored the clinical toolkit, and HPP provided editorial support, design and translation.

The policy toolkit includes several case studies from FFN members across the world. It also offers tools for policy engagement, including templates for processes such as stakeholder mapping and SWOT analysis.

Both toolkits were launched in October 2020. They are available in English, Arabic, Mandarin and Spanish, and the clinical toolkit is also available in Italian.

Key partners and stakeholders

We are grateful to the following individuals who provided their time to be interviewed for the policy toolkit:

  • Tanawat Amphansap, General Secretary, Fragility Fracture Network Thailand; Chief, Osteoporosis and Geriatric Excellence Centre, Police General Hospital, Bangkok, Thailand
  • Derrick Chan, Clinical Professor, Internal Medicine; Superintendent, National Taiwan University Hospital Chu-Tung Branch, Taiwan
  • Jacqueline Close, Scientific Committee Deputy Chair, Fragility Fracture Network; Orthogeriatrian, Prince of Wales Hospital and Clinical Director, Falls, Balance and Injury Research Centre, NeuRA, UNSW, Sydney, Australia
  • Cyrus Cooper, President, International Osteoporosis Foundation; Professor of Rheumatology and Director, MRC Lifecourse Epidemiology Unit; Vice-Dean of Medicine, University of Southampton, Professor of Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
  • Gill Hall, Independent Contractor, In Good Hands Ltd, New Zealand; past Health System Lead Advisor, Accident Compensation Corporation, New Zealand
  • Karen Hertz, Advanced Nurse Practitioner, Royal Stoke University Hospital, University Hospital of North Midlands, UK
  • Ravi Jain, Director, Ontario Osteoporosis Strategy, Osteoporosis Canada, Canada
  • Famida Jiwa, President, CEO, Osteoporosis Canada, Canada
  • Adriana Machado, Geriatrician, Universidade Estadual Paulista Júlio de Mesquita Filho, Brazil
  • Finbarr Martin, Consultant Geriatrician, Professor of Medical Gerontology, Guy’s and St Thomas’ NHS Foundation Trust and Population Health Sciences, King’s College London, UK
  • David Marsh, Regionalisation Committee Chair, Fragility Fracture Network; Emeritus Professor of Orthopaedics, University College London, UK
  • Paul Mitchell, Chair of the FFN Communications Committee, Fragility Fracture Network; Adjunct Senior Lecturer, School of Medicine, Sydney Campus, University of Notre Dame, Australia; Honorary Departmental Senior Research Fellow, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
  • Elias Panagiotopoulos, Orthopaedic Surgeon, Professor, Patras University Hospital, Greece
  • Maroun Rizkallah, Deputy Treasurer, Fragility Fracture Network; Orthopaedic Surgeon, Bellevue Medical Centre, Hotel Dieu de France Hospital, Lebanon
  • William O. Shaffer, Chief Medical Officer, American Association of Orthopaedic Surgeons, USA
  • Cathie Sherrington, Professor of Musculoskeletal Health, The University of Sydney, Australia
  • Robyn Speerin, FFN Board Member, Member Scientific Committee, Co-Lead Secondary Fracture Prevention Special Interest Group; Research Project Manager, The University of Sydney, Australia
  • Irewin Tabu, Regionalisation Committee Deputy Chair, Fragility Fracture Network; Orthopaedic Surgeon, University of the Philippines Manila – Philippine General Hospital; Chair, Fragility Fracture Network Philippines
  • Diane Theriault, Chief Scientific Officer, Fracture Liaison Service, Osteoporosis Canada, Canada
  • Aasis Unnanuntana, Vice-President, Fragility Fracture Network Thailand; Chief of Orthogeriatrics and Metabolic Bone Diseases, Faculty of Medicine, Mahidol University; Orthopaedic Surgeon, Siriraj Hospital, Bangkok, Thailand

Project funding

The policy toolkit was fully funded via an unrestricted grant from UCB and its content developed independently by The Health Policy Partnership on behalf of the Fragility Fracture Network.