What is being done and why
Nationally
NHS England: Transforming the Frailty Pathway 3
NHS England is implementing a nationwide shift from hospital‑centred to community-based care, delivered through the Neighbourhood Health Service. Key components include:
- Managing increasing frailty demand by shifting more care into the community.
- Integrated working across primary care, social care, community health, mental health, acute services and VCSE partners.
- Improving patient flow, reducing non-elective admissions and reliance on temporary care beds.
NHS Long Term Plan11
NHS policy requires all major A&E departments to implement Acute Frailty Services and provide rapid assessment for older adults.
NICE Guidance & Frailty Model (FRAIL Framework)11
NICE provides nationally endorsed standards supporting:
- Frailty identification
- Multidisciplinary frailty assessment (CGA)
- Falls risk assessment
- Intervention planning and medication review
NHS England Frailty Resources12
Nationally available, these include:
- NHS RightCare Frailty Toolkit
- Frailty Framework of Core Capabilities
- BGS Comprehensive Geriatric Assessment toolkit
- National falls prevention resources
Proactive Care Framework (2023‑present)13
Supports consistent nationwide delivery of proactive frailty care, including:
- Case identification (using eFI)
- Holistic assessment
- Personalised care and MDT working
- Continuity of care
Regionally
North East & North Cumbria Ageing Well Network14
The NENC ICS has a dedicated Ageing Well Network, with professionals contributing to regional frailty planning and service transformation. This includes clinical leads, frailty nurses, geriatricians and community specialists.
NIHR‑Funded Frailty Pathways Toolkit (North East & North Cumbria) 14
Regionally significant, this toolkit provides a standardised framework for:
- Planning frailty pathways
- Operational delivery
- Evaluation of frailty services across settings
Developed with North East & North Cumbria expert contributors, it strengthens frailty integration across the ICS.
Integrated Frailty Pathway (FrailtyPath.co.uk)
Widely used across the region, offering:
- Guidance on identifying causes of deterioration
- Comprehensive assessment pathways
- Support for integrated, personalised, compassionate care
Falls & Fragility Pathways
The North East region uses NHS England’s national falls resources, which highlight:
- Over one‑third of people aged 65+ fall annually
- High-cost hip fracture burden
- Need for community-based falls prevention and reconditioning approaches
Locally
Community Frailty Pathways
Delivered via NENC ICS and local Primary Care Networks:
- Frailty identification using electronic Frailty Index
- Proactive, MDT frailty assessments
- Falls risk assessments and medication reviews
These services form part of the national neighbourhood care model described by NHS England.
Local Falls Prevention Services
- Home/environmental risk assessment
- Strength, balance, and reconditioning programmes
- Referrals to community therapy (OT/physio).
Aligned with national falls-prevention guidance and ICS implementation practice.