‘Focus on frailty’ as NHS looks to provide coordinated support
A SUSTAINABLE and coordinated way of dealing with frailty in Shetland’s population is being worked on by NHS Shetland.
The health board said the ambition was not to create a new dedicated service for frailty, but to work across the existing care, health and community services to ensure people receive the right support earlier.
Planning head Lucy Flaws also said they wanted people to be able to recover as well as possible after crisis and to remain independent for longer.
It comes from a briefing note published by Shetland Islands Council, with Flaws delivering a briefing entitled “focus on frailty” to elected members earlier this month.
Frailty is a condition in which recovery from illness or injury can take longer or be more difficult. It is more common with age, although younger people can also live with frailty.
Flaws said that Shetland’s older population has grown significantly and is projected to continue growing.
That was increasing the importance of preventing avoidable crisis, maintaining independence and using limited health an22d care capacity well, she said.
The local focus on frailty programme has been used to connect existing teams and to test how support could be offered earlier, how people could receive a better response when at crisis point, and how care capacity could be released.
“The programme is now moving towards evaluation and development of a business case for a sustainable longer-term approach,” Flaws said.
“The aim is to organise existing services around people, not to add another layer of referral or create a separate ‘frailty service’.”
She said they recognised how challenging it could be for people “when support is not joined up, and they have to re-tell their story”.
“The greatest opportunity is to reduce fragmentation of care or support, particularly where people move between services or have several needs at once.
“Better coordination can reduce duplication, delay and the risk that people fall through gaps.”
Flaws said that work had been ongoing on developing how frailty was handled, with current fixed-term funding used to enable testing.
However this “also creates workforce and sustainability risks”, she said.
“The next phase must distinguish the temporary resource needed to test and evaluate from the minimum ongoing capacity needed to maintain effective ways of working,” Flaws continued.
“External, short-term funding will not be extended, and there is likely to be a need for some degree of additional resource to deliver an effective function that is fit for the future.”
Flaws told elected members that they would use the learning from the focus on frailty programme to develop a business case, which would set out the longer-term frailty plans for Shetland.
This would include a minimum sustainable offering and how it would remain integrated with the existing services, she added.
