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Identification and management of frailty in English primary care: a qualitative study of national policy
BACKGROUND: 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...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Royal College of General Practitioners
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330193/ https://www.ncbi.nlm.nih.gov/pubmed/32184213 http://dx.doi.org/10.3399/bjgpopen20X101019 |
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author | Alharbi, Khulud van Marwijk, Harm Reeves, David Blakeman, Tom |
author_facet | Alharbi, Khulud van Marwijk, Harm Reeves, David Blakeman, Tom |
author_sort | Alharbi, Khulud |
collection | PubMed |
description | BACKGROUND: 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. AIM: To explore the implementation of a national policy on frailty identification and management in English primary care. DESIGN & SETTING: Qualitative study entailing interviews with primary care professionals in the North of England. METHOD: Semi-structured interviews were conducted with GPs (n = 10), nurses (n = 6), practice managers (n = 3), and health advisors (n = 3). Normalisation process theory (NPT) and ‘system thinking’ provided sensitising frameworks to support data collection and analysis. RESULTS: 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. CONCLUSION: 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. |
format | Online Article Text |
id | pubmed-7330193 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Royal College of General Practitioners |
record_format | MEDLINE/PubMed |
spelling | pubmed-73301932020-07-07 Identification and management of frailty in English primary care: a qualitative study of national policy Alharbi, Khulud van Marwijk, Harm Reeves, David Blakeman, Tom BJGP Open Research BACKGROUND: 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. AIM: To explore the implementation of a national policy on frailty identification and management in English primary care. DESIGN & SETTING: Qualitative study entailing interviews with primary care professionals in the North of England. METHOD: Semi-structured interviews were conducted with GPs (n = 10), nurses (n = 6), practice managers (n = 3), and health advisors (n = 3). Normalisation process theory (NPT) and ‘system thinking’ provided sensitising frameworks to support data collection and analysis. RESULTS: 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. CONCLUSION: 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. Royal College of General Practitioners 2020-03-18 /pmc/articles/PMC7330193/ /pubmed/32184213 http://dx.doi.org/10.3399/bjgpopen20X101019 Text en Copyright © 2020, The Authors https://creativecommons.org/licenses/by/4.0/ This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | Research Alharbi, Khulud van Marwijk, Harm Reeves, David Blakeman, Tom Identification and management of frailty in English primary care: a qualitative study of national policy |
title | Identification and management of frailty in English primary care: a qualitative study of national policy |
title_full | Identification and management of frailty in English primary care: a qualitative study of national policy |
title_fullStr | Identification and management of frailty in English primary care: a qualitative study of national policy |
title_full_unstemmed | Identification and management of frailty in English primary care: a qualitative study of national policy |
title_short | Identification and management of frailty in English primary care: a qualitative study of national policy |
title_sort | identification and management of frailty in english primary care: a qualitative study of national policy |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330193/ https://www.ncbi.nlm.nih.gov/pubmed/32184213 http://dx.doi.org/10.3399/bjgpopen20X101019 |
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