Identification and management of frailty in English primary care: a qualitative study of national policy

Policymakers are directing attention to addressing the needs of an ageing population. Since 2017, general practices in England have been contractually required to identify and code 'frailty' as a new clinical concept and, in doing so, support targeted management for this population with th...

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Bibliographic Details
Published in:BJGP open 2020, Vol.4 (1), p.bjgpopen20X101019
Main Authors: Alharbi, Khulud, van Marwijk, Harm, Reeves, David, Blakeman, Tom
Format: Article
Language:English
Subjects:
frailty
general practice
normalisation process theory
policy
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Summary:Policymakers are directing attention to addressing the needs of an ageing population. Since 2017, general practices in England have been contractually required to identify and code 'frailty' as a new clinical concept and, in doing so, support targeted management for this population with the aim of improving outcomes. However, embedding frailty policies into routine practice is not without challenges and little is currently known about the success of the programme. To explore the implementation of a national policy on frailty identification and management in English primary care. Qualitative study entailing interviews with primary care professionals in the North of England. Semi-structured interviews were conducted with GPs ( = 10), nurses ( = 6), practice managers ( = 3), and health advisors ( = 3). Normalisation process theory (NPT) and 'system thinking' provided sensitising frameworks to support data collection and analysis. Primary care professionals were starting to use the concept of frailty to structure care within practices and across organisations; however, there was widespread concern about the challenge of providing expanded care for the identified needs with existing resources. Concerns were also expressed around how best to identify the frail subpopulation and the limitations of current tools for this, and there was a professional reticence to use the term 'frailty' with patients. Findings suggests that additional, focused resources and the development of a stronger evidence base are essential to facilitate professional engagement in policies to improve the targeted coding and management of frailty in primary care.
ISSN:2398-3795
2398-3795
DOI:10.3399/bjgpopen20X101019