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Delivering frailty services

Thinking differently and creating a more positive attitude towards frailty can improve care outcomes and experiences – and ultimately dispel the myth that frailty is an inevitability we're powerless to change.

This is the view put forward in a new article from Adrian Woolmore, a commissioning director in Capita (health) and Professor Simon Brake, chief executive and director, Coventry and Rugby GP Alliance.

With a forecast increase of 4.7m people aged over 75 by 2040, a dramatic growth in long term conditions and increasing mental health and social isolation issues, frailty is rapidly becoming a top priority for nearly all health economies.

There is a growing body of evidence that frailty is not confined to older people and that it can be treated as a long term condition. However, while commissioners and clinicians are recognising the need to redefine frailty, many struggle to put this into practice.

Frailty has not been clearly defined in the past, but recent developments are changing this such as the Electronic Frailty Index and the International Consortium for Health Outcomes Measurement (ICHOM) standard outcomes for older people. However, these developments are not moving quickly into health and social care services designed to specifically support frail people.

To treat frailty as a long term condition, proactive and dedicated primary care services are needed alongside more established and reactive services situated in emergency departments and acute care wards.

This model has been proven by organisations we work with. For example, Coventry and Rugby GP Alliance has introduced a primary care-led, integrated management approach into their frailty pathway. This allows them to identify citizens at risk and support them in their homes, helping them live independently and reduce pressures on urgent and emergency services. Furthermore, it optimises the use of community and ambulatory support services, by utilising outpatient clinics for falls, continence and comprehensive geriatric assessments and involving voluntary and community organisations.

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