Frailty Hub: Setting up and developing frailty services

Knowing where to start when setting up a new service can be overwhelming. The following publications provide an overview of the key principles underpinning effective healthcare for older persons.

• Joining the dots: A blueprint for preventing and managing frailty in older people - BGS
  The report provides an overview of the core features needed to support system leaders and commissioners of health and social care services in the development of high-quality integrated care systems for older people. 
   

• Making healthcare systems fit for an ageing population - Kings Fund
  This provides a useful start for local service leaders and practitioners wanting to understand the key components of improving care in an older persons healthcare journey. It outlines key standards of care, followed by the evidence based strategies to improve care and examples of effective local practice.
   

• Front door frailty:  Advice on setting up services - BGS
  In this document, the BGS sets out five principles that should underpin front door frailty services. It provides tips on establishing services from those who have been through the process. 
   

• Fit for Frailty Part 2 - BGS
  This publication is aimed at GPs, geriatricians, Health Service managers, Social Service managers and Commissioners of Services. As well as providing an overview of the political framework for the development of frailty services, it provides guidance on development, commissioning and management of services for people living with frailty in community settings.
   

• HOW CGA Service level toolkit
  This toolkit is aimed at hospital staff within any discipline who want to improve the care for older people living with frailty in their service. It provides a step by step approach about how you can use quality improvement methodology to support both identifying and then addressing the problems within your service.
   

• Comprehensive geriatric assessment for frail older people in acute hospitals: the HoW-CGA mixed methods study
  This mixed-methods study describes the development, implementation and evaluation of delivering a hospital-wide comprehensive geriatric assessment (HoW CGA toolkit).

The following resources highlight different successful local initiatives that have led to an improvement in the care of older people.

• Acute Frailty Network
  The Acute Frailty Network aims to optimise acute care of frail older people in England. These case studies explore different methods acute hospital trusts have improved the care of older persons living with frailty.
   

• Improving the flow of older people - Sheffield Teaching Hospital NHS Trust’s experience of the Flow Cost Quality improvement programme
  This case study provides an example of how a team at Sheffield Teaching Hospitals NHS Trust identified a local problem in the emergency pathway for older people and implemented effective change. This work was undertaken as part of the Health Foundation’s Flow Cost Quality programme.
   

• Integrated care for older people with frailty: Innovative approaches in practice - RCGP & BGS
  A case study-based report that aims to support GPs and geriatricians in delivering integrated care within their locality, through sharing effective initiatives that have developed nationwide.
   

• Healthy ageing and managing frailty in older age strategy - Together we're better (Stoke-on-Trent)
   

• Unplanned Hospital Care Acute Frailty Service Specifications – Guidance Document (London)
  This service specification helps Trusts develop their same day emergency care frailty service within integrated care pathways for those living with frailty. It provides a way to benchmark the local service as bronze, silver or gold with a view to continuous enhancement of services. (NHS Future account required - see here for more information).