Core20PLUS5 Framework: Reducing healthcare inequalities among older people
This framework for reducing healthcare inequalities among older people is based on similar existing frameworks from NHS England for adults, children and younger people. It aims to help identify people within the population who have unequal access to and experience of healthcare, and to target action to counter that inequality.
Core20PLUS5 is a framework originally developed by NHS England to help Integrated Care Systems (ICSs) identify people within the population who have unequal access to and experience of healthcare, and to target action to counter that inequality. There are frameworks for adults and also for children and young people.
In 2025, the BGS and RCGP decided to work together to create a similar framework for older people. The Core20Plus5 Framework for older people uses the same one-page format as the original frameworks. It divides the equalities approach into three areas.
- Core 20 is a geographical measure, identifying the most deprived 20% of the national population.
- ‘Plus’ is chosen by the ICS to reflect a local minority group within those aged over 65 who experience poorer-than-average health experience and outcomes.
- The third part of the framework identifies five clinical areas relevant to the care of older people.
For these five areas - frailty, dementia, falls prevention and management, multiple long-term conditions and polypharmacy, and end of life care – measures of success are offered, to help ICSs track progress in delivering greater equality.
