Aim(s)
- To reach consensus that Northern Ireland should identify frailty.
- To develop a “menu” of the recommended assessment tools for frailty, which can be applied in a range of settings by a range of professional and non-professional staff. This should take account of all sectors of care.
Objectives
- Consider current practice in NI in terms of frailty identification, including evaluations of prototypes funded through the Frailty Network.
- Review evidence and best practice from elsewhere around the identification of frailty
- Consider the role of a range of staff across all sectors in the identification of frailty
- Reach agreement on how, by whom and in what setting(s) frailty should be identified
- Consider and make recommendations on the best means of sharing frailty scores / information
- Review existing assessment tools and their transferability to NI
- Engage with a range of stakeholders to determine current practices
- Consider and make recommendations for the sharing of assessment information amongst relevant staff groups / sectors
Arrangements
The Task and Finish Group will meet on a monthly basis, with a schedule of dates agreed in advance. Venues and times will take account of the needs of members. Papers for meetings should be issued at least one week prior to each meeting. Co-Chairs should ensure that all members have sufficient opportunity to contribute to discussion and that no decisions are taken outside of the group. Administrative and business / managerial support for the group will be provided by the Public Health Agency.
Accountability
The group will receive direction from and be accountable to the Expert Advisory Panel on Frailty and will provide an update for consideration on a quarterly basis. The Task and Finish Group will also take account of the advice of the Expert by Experience Community in the development of all plans and recommendations.
Deliverables and Timescales
| Item | Timescale | Notes |
| Short update to Expert Panel | Feb 2020 | |
| Reach consensus on identification of frailty in NI
Consider range of available tools, staff groups and services / settings where they may be used |
March 2020 |
|
| Year end report to Expert Panel | March 2020 |
Key Reports / Information Requirements
Delivering Together 2026 – “every one of us to lead long, healthy and active lives. People today want to lead full and productive lives, staying independent for longer. In line with wider societal changes, we all expect improved access, choices and control when it comes to public services… Therefore, we want to see a future in which:
- people are supported to keep well in the first place with the information, education and support to make
- informed choices and take control of their own health and wellbeing;
- when they need care, people have access to safe, high quality care and are treated with dignity, respect
- and compassion;
- staff are empowered and supported to do what they do best; and
- our services are efficient and sustainable for the future
Programme for Government 2016-21 – Outcome 4: We enjoy long, healthy, active lives. This outcome is about improving the health of everyone, giving them the best opportunity to live longer and healthier lives. It is about ensuring that people get the right care, of excellent quality, at the time of need. It is about keeping people healthy, preventing them from needing health interventions. In part, this means giving people the information and support they need to make healthy lifestyle choices. It also means tackling issues related to deprivation and poverty that are linked to poor health outcomes.
The Role of the Executive We will make our contribution by:
Creating an excellent health service; ensuring people get the right treatment at the time of need.
Implementing excellent public health strategies and interventions which aid people to live healthier lives and give them the means to do so.
- Providing people with the right information to allow them to make educated and informed choices about how to live their lives in a healthier way.
- Providing children with the best start in life, supporting parents in their role.
- Tackling poverty and deprivation.
PHA Corporate Plan 2017-21 – “All older adults are enabled to live healthier and more fulfilling lives”. The following actions were identified to support this:
- develop and implement multi-agency healthy ageing programmes to engage with and improve the health and wellbeing of older people;
- promote appropriate intervention programmes within all settings to prevent, detect and manage mental ill health and its consequences;
- promote inclusive, inter-generational physical and mental health messages and initiatives that enable longer, healthier and more fulfilling lives;
- protect the health of older adults through immunisations and screening;
- support programmes and initiatives, including research, e-health and technology-based approaches, that promote independence and the PHA is seeking to move to a more outcomes based approach and self –management.
Rethinking Frailty: What really matters to older people (Age NI 2018) – key points:
- The subject of frailty is one that is important to older people in Northern Ireland.
- The terminology is not viewed in a positive light, with the word frailty being associated with loss of independence, inability to look after oneself and a decline in wellbeing.
- The view of frailty does not fit with what older people believe makes a good life; physical wellbeing, psychological and emotional wellbeing and independence.
- Older people do not identify with the term frail and feel that use of this term may act as a barrier for older people in seeking help and support.
- Older people believe frailty encompasses difficulties beyond physical wellbeing including mental wellbeing, social contact and financial security. The services that they feel would be beneficial reflect this scope.
- There is an opportunity for older people to engage with support at a range of contact points and older people’s view of frailty, in that it is not inevitable, shows an opportunity for support.
BGS Fit for Frailty Parts 1 & 2 (see recommendations to support agreement of outcome measures)
Part 1: https://www.bgs.org.uk/sites/default/files/content/resources/files/2018-05-23/fff_full.pdf
Part 2: https://www.bgs.org.uk/sites/default/files/content/resources/files/2018-05-23/fff2_full.pdf
Useful Links:
https://www.england.nhs.uk/ourwork/clinical-policy/older-people/frailty/frailty-risk-identification/
https://www.frailtytoolkit.org/category/asess-tools/
BGS Silver Book https://www.bgs.org.uk/sites/default/files/content/attachment/2018-05-01/Silver%20Book%202012%20Complete.pdf
NHS Right Care https://www.england.nhs.uk/rightcare/wp-content/uploads/sites/40/2019/07/frailty-toolkit-june-2019-v1.pdf
Edmunton Scale http://www.nscphealth.co.uk/edmontonscale-pdf
GIRFT (Getting it Right First Time) https://gettingitrightfirsttime.co.uk/
Comprehensive geriatric assessment for frail older people in acute hospitals: the HoW-CGA mixed-methods study https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr07150#/abstract
Membership
| Mary O’Boyle | Co-Chair / Nursing | NHSCT | Mary.oboyle02@northerntrust.hscni.net |
| Claire Burnside | OT | SET | Claire.Burnside@setrust.hscni.net |
| Katherine Hudson | Dietetian | NHSCT | katherine.hudson@northerntrust.hscni.net |
| TBC – other AHP reps | |||
| David Florida James | Age NI | Age NI | djfj65@mac.com |
| Peter Donnelly | PPI | PPI | gripfist19@yahoo.co.uk |
| Ann Murray | Age NI | Age NI | Anne.Murray180@outlook.com |
| Dr Vanessa Chambers | Community Pharmacy | CPNI | vanessac@communitypharmacyni.co.uk |
| Dr Mary McDaid | GP / ICP | Southern ICP | mbmcdaid@hotmail.co.uk |
| Yvonne Murphy | ACAH Manager | SHSCT | Yvonne.Murphy@southerntrust.hscni.net |
| Gillian McAleer | Community Nursing Manager | BHSCT | gillian.mcaleer@belfasttrust.hscni.net |
| Martina McCusker | Clinical Coding Manager | Ehealth HSCB | martina.mccusker@hscni.net |
| Dr Emily McIntosh | Co Chair / Consultant Geriatrician | NHSCT | Emily.McIntosh@northerntrust.hscni.net |
| Dr Lynne Armstrong | Consultant Geriatrician | SET | Lynne.Armstrong@setrust.hscni.net |
| Claire McFallhttps://frailtynetwork.hscni.net/wp-admin/edit.php?post_type=staff | Palliative Care | NHSCT | Claire.McFall@northerntrust.hscni.net |
| Janice Colligan | Operations Manager / Lead Nurse | SET | janice.colligan@setrust.hscni.net |
| Mandy Cowden | Manager | CLARE CIC | m.cowden@clare-cic.org |
| Diane Walker | Palliatve Care in Partnership | HSCB | diane.walker@hscni.net |
| Dr Gary Mitchell | QUB | Gary.Mitchell@qub.ac.uk | |
| Justin O’Neill | ANP | NHSCT | justin.oneill@northerntrust.hscni.net |
| Joanne McElmeel | Physio | SHSCT | joanne.mcelmeel@southerntrust.hscni.net |
| Nuala Dunne | OT | WHSCT | nuala.dunne@westerntrust.hscni.net |
| Carmel Darcy | Consultant Pharmacist | WHSCT | Carmel.Darcy@westerntrust.hscni.net |
| Ruth Donaldson | Social Care Lead | HSCB | Ruth.Donaldson@hscni.net |
| Dr Rose McCullagh | GP | RCGPNI | Rosemccullagh182@gmail.com |
| Carmel Darcy | Consultant Pharmacist | WHSCT | Carmel.Darcy@westerntrust.hscni.net |
| Ruth Donaldson | Social Care Lead | HSCB | Ruth.Donaldson@hscni.net |
| Dr Kevin Brazil | QUB | k.brazil@qub.ac.uk | |
| Dr Ciaran Trolan | Consultant Geriatrician | SET | Ciaran.Trolan@setrust.hscni.net |
| Ciaran McKenna | SI Lead | NIAS | Ciaran.McKenna@nias.hscni.net |
| Cara Parker | Home Manager | Landsdowne Care Home Belfast | caraparkerfshc@icloud.com |