People living with frailty can experience a number of complications with their health. They often need to manage multiple long-term conditions, are at risk of worsening health through falls, of developing conditions such as anxiety and depression, and they are more likely to have unplanned hospital admissions.
In light of this, identifying people with frailty has been a key priority for the NHS, forming part of the GP contract since 2017/18 and in 2024/25 through the use of the electronic frailty index. This tool aims to target a small number of interventions at those most at risk of hospitalisation, nursing home admission and death.
If an individual benefits from early interventions within the community before their health deteriorates, the risk of a hospital admission can be minimised. This is important because, although a stay in hospital is sometimes necessary, there are inherent risks associated with both admission and a prolonged stay. For example, people can be exposed to healthcare acquired infections, and suffer with deconditioning and a general deterioration in their sense of independence and wellbeing. It is often the case that people living with frailty are particularly susceptible to these risks, and do not recover to previous levels of health or independence after long periods in hospital.
Supporting people with frailty to stay well at or close to home is also important in reducing pressure across the whole health and care system, particularly during periods of heightened pressure, for example over winter. The winter resilience plan for 2023/24 highlighted the importance of bolstering frailty services to avoid unnecessary hospital admissions.
For people with frailty, access to both preventative and urgent care delivered in the community can reduce the need for ambulance callouts and hospital admissions, improving flow through the system.
Hospital admissions are essential in some cases, and providing the right support for people with frailty to return home after a stay in hospital is another important part of the puzzle. A well-resourced, enhanced approach to intermediate care can support people with frailty with rehabilitation and reablement support, promoting independence and reducing the risk of readmissions.
