Building the Neighbourhood Frailty Workforce: Evaluation of a Frailty Training Programme for Holistic Needs Assessors

Introduction: The Government's Neighbourhood Health Framework identifies frailty as a priority for Integrated Neighbourhood Teams (INTs). People aged over 75 years with moderate-to-severe frailty represent only 3–5% of the population but account for over one-quarter of non-elective hospital admissions. Delivering proactive neighbourhood-based frailty care requires a workforce skilled in early frailty identification and personalised care assessment. We developed a multidisciplinary education programme to build capability among Holistic Needs Assessors, a new role supporting proactive frailty care within Lambeth INTs.

Method: Ten staff from nine general practices within one of Lambeth’s five INTs were nominated to undertake a structured frailty education programme. Seven participants (five healthcare assistants, one nursing associate and one care coordinator) completed all four interactive half-day sessions delivered by a consultant geriatrician and advanced frailty practitioner. The programme combined a structured one-page holistic frailty assessment template, case-based learning, validated screening tools and neighbourhood referral pathways. A mixed-methods evaluation examined confidence change across six frailty competencies using pre- and post-course questionnaires alongside qualitative feedback.

Results: Five participants had no previous frailty training despite contact with people living with frailty.  Training was rated highly, with 75-100% agreeing objectives were clear and relevant.  Median confidence improved across all competencies, from 1.5-2.5 pre-course to 4.5-5.0 post-course, with greatest gains in holistic assessment, care planning and frailty screening tool use.  Participants reported increased confidence in person-centred conversations, risk identification, multidisciplinary working and communication, with many intending immediate implementation in practice.

Conclusion: A practical multidisciplinary frailty education programme improved workforce confidence and perceived capability to deliver structured holistic assessments using CGA within an Integrated Neighbourhood Team. This scalable model supports neighbourhood health by equipping primary care teams to identify frailty earlier, undertake holistic assessment and coordinate person-centred care. Phase 2 will evaluate translation into clinical practice and patient outcomes.