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Frailty from policy to a personal perspective
For the last nine months Chris Harris has been working as a programme support officer in NHS England’s Medical Directorate – focusing on frailty, its identification and management, and how the NHS is responding to the frailty ‘challenge’ set out in the Five Year Forward View. With the NHS’s 70th birthday quickly approaching, he says now is the time to talk about how we age, and pertinently asks, how we can age well.
The work I have been supporting is going well and results so far are encouraging. At a national level all patients aged 65 and over registered with a GP in England are now for the first time subject to an annual frailty assessment, with case finding at population level supported by the electronic Frailty Index (eFI). This is important to me because early indicators of impact are positive with over 2.3 million patients aged 65 and over already benefitting from the assurance of a frailty assessment and the opportunity it can provide to increase understanding of how to support individuals to age well – something I’m learning more about each day.
At a local level, clinicians and commissioners have access to new data on frailty prevalence to help inform decisions about what support and care to provide to people living with frailty. As we move into 2018/19 the opportunities to build on this will be supported by regional frailty events throughout April and May, the publication of both an economic analysis of the costs of frailty across a health and care economy, and an education and training framework.
Implementation is not without its challenges. Feedback from front line staff and analysis of data returns shows that some practices have automatically coded patients directly from the eFI without confirming a diagnosis. This has the potential to misidentify patients at risk of living with frailty and create uncertainty, in response to which we have issued guidance.
The work, its impact and its challenges have introduced me to a lot of people, across the health and care system, who are working every day to improve not just the identification and management of frailty, but also to improve our understanding and support available to older people. As an individual I have been inspired by the commitment shown by those I have engaged with, to do something personally to make difference outside of work. I am now volunteering as an Age UK telephone befriender of a person experiencing frailty and its effects, particularly social isolation. For me and my employer (NHS England) this requires having the time for a regular weekly 30 minute phone call with the person I am befriending.
It is early days in our evolving relationship, but I’m already discovering that my work as a volunteer also benefits me. I enjoy the chats, and I’m gaining a much better, real-life understanding of an older person’s perspective on life, care and ageing. It’s been powerful in motivating me to make a real difference in what I do on a day to day basis, both in and out of work.
If you are interested in finding out more about Age UK’s befriending programme see their website.