Frailty in Primary Care: Interventions and Opportunities

With population ageing and health and social care challenges, building resilience and maintaining functionality have never been more important in community dwelling older people. This chapter explores whether this can be achieved by frailty identification and management in primary care. In 2017, the GP contract in England introduced routine frailty identification and management. The potential of this initiative was hindered by a lack of evidence base for effective interventions once frailty is identified, impractical identification tools, and some negative perceptions of frailty. We summarise the evidence we contributed from 2019 to 2023 on effectiveness and feasibility of primary care interventions to reverse frailty and build resilience and emphasise the importance of involving older patients in co-designing interventions. We build on our co-designed intervention, informed by our systematic review, meta-analysis, feasibility study, and randomised-controlled trial to show how frailty may be reversed and resilience enhanced by a simple, low-cost primary care intervention. We highlight the potential benefits that a frailty and resilience paradigm in primary care could offer for informing patterns of health and social care utilisation and integrated care services.