The National Frailty Improvement Collaborative is focused on learning how to transform care for people living with frailty.

The aims of the Collaborative are to:

• use improvement methodology to test and learn how to implement evidenced based frailty-attuned care
• learn how to shift care from hospital to community settings
• generate evidence and insights to inform national policy and planning guidance.

This work supports the broader ambition to shift care from hospitals to community settings and build a sustainable, place-based neighbourhood health service.

Seven collaborative discovery sites, one per region, were selected from the 31 applications to the national call for expressions of interest. They are:

1. South and East Essex, Mid and South Essex Integrated Care Board
2. Central Lancashire, Lancashire and South Cumbria Integrated Care Board
3. Surrey Downs, NHS Surrey Heartlands Integrated Care Board
4. North and South Gloucestershire, Gloucestershire Integrated Care Board
5. Kingston and Richmond, Southwest London Integrated Care Board
6. Wolverhampton, Black Country Integrated Care Board
7. Hull and East Riding, Humber and North Yorkshire Integrated Care Board

These sites will work with the national team, local partner organisations and place-based frailty services, to further develop and scale their frailty offer. The aim is to achieve some initial measurable impacts on performance and outcomes by next winter 2026/27 alongside capturing the learning about behaviours, relationships, ways and working and processes that deliver improvements.

Overview of the collaborative methodology

The programme adopts the Breakthrough Series (BTS) Collaborative framework – a proven approach for accelerating improvement in healthcare. This includes:

Pre-collaborative

The topic of frailty attuned care has been selected, and a small central collaborative ‘faculty’ team has been recruited. Sites have formed their core improvement teams who will lead the work. Frailty attuned improvement bundles which are improvement guides to deliver frailty attuned care will be developed through the collaborative drawing on best practice and the evidence base learning from the experience of testing.

Learning sessions

Three in-person sessions will be held where teams will share progress, work collaboratively, build relationships, learn from experts, and plan next steps.

Action periods

In the intervals between sessions the site teams will test changes (using Plan-Do-Study-Act cycles), collect data, and implement improvements locally. The sites will share discovery and learning through regular progress reports.

All teach, all learn

A culture of transparency and mutual learning, with regular sharing of results and challenges is inherent in the collaborative.

Final session

Sites will attend a final session to present back progress over the year and reflect on learning. Initial analysis will be presented on the impact of the collaborative against the aims listed above.

Subscribe to the NHS IMPACT bulletin for regular updates on the National Frailty Improvement Collaborative.