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GP views on the routine identification of older people living with frailty in primary care

Mulla, Ebrahim; Orton, Elizabeth; Kendrick, Denise


Ebrahim Mulla

Professor of Primary Care Research


© British Journal of General Practice 2020. Background: To meet the challenges of an ageing population, the updated 2017/18 NHS GP contract requires primary care providers to use evidence-based frailty identification tools to risk-stratify all patients aged >65 years. Those patients flagged as moderately or severely frail should be clinically reviewed and if severe frailty is confirmed, providers have been asked to consider offering relevant interventions, with the overall aim of enabling these patients to live well for longer. However, there is limited knowledge about how this frailty contractual requirement is being operationalised in primary care. AIM: To improve understanding of the barriers and facilitators GPs encounter when routinely identifying, risk-stratifying and providing interventions for people living with frailty in primary care. Method: This was a two-part study: an initial survey via online questionnaire, with participants selected by maximum variation sampling to be followed up with a semi-structured telephone interview. All GPs working in the East Midlands region (Derbyshire, Leicestershire, Lincolnshire, Nottinghamshire, and Northamptonshire) were eligible to take part. The online questionnaire was analysed using descriptive statistics. Interview transcripts were analysed using framework analysis to identify key themes. Results: In total, 188 GPs responded to the survey. Eighteen GPs were interviewed. Four themes were identified: 1) beliefs about stratification and pro-active identification of frailty; 2) frailty stratification tools; 3) managing complexity, resources and models of care; and 4) drivers of GP behaviour. Conclusion: The study findings will inform the further development of NHS England policy on the frailty contractual requirement for primary care providers.


Mulla, E., Orton, E., & Kendrick, D. (2020). GP views on the routine identification of older people living with frailty in primary care. British Journal of General Practice, 70(Supplement 1),

Journal Article Type Article
Conference Name BJGP Research Conference 2020
Acceptance Date Jun 18, 2020
Online Publication Date Jun 18, 2020
Publication Date Jun 1, 2020
Deposit Date Jul 1, 2020
Publicly Available Date Jul 3, 2020
Journal The British journal of general practice : the journal of the Royal College of General Practitioners
Print ISSN 0960-1643
Electronic ISSN 1478-5242
Publisher Royal College of General Practitioners
Peer Reviewed Peer Reviewed
Volume 70
Issue Supplement 1
Keywords Family Practice
Public URL
Publisher URL


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