Khan Nimra, Randhawa Gurch, Hewson David
Institute for Health Research University of Bedfordshire Department of Psychiatry University of Oxford, UK.
Institute for Health Research University of Bedfordshire, UK.
Int J Integr Care. 2023 Mar 23;23(1):15. doi: 10.5334/ijic.6537. eCollection 2023 Jan-Mar.
The NHS England General Medical Services 2017-18 contract made it mandatory for general practices in England to identify and manage older people proactively. In response to the national policy, the Luton Framework for Frailty (LFF) programme was developed to target older residents of Luton and offer interventions according to their frailty level. The aim of this study was to gain a deeper understanding of the LFF and the factors that affect the implementation of a proactive integrated care service for older people with different frailty levels (OPDFL).
We undertook document analyses and conducted semi-structured interviews with stakeholders to create a 'thick description' that provides insights into the LFF.
Healthy ageing interventions bring beneficial outcomes but to increase the uptake they should be co-produced with older people. A common electronic system within primary care and multidisciplinary team meetings (MDT) aid implementation. However, variation in implementation across Luton, different levels of buy-in for MDT, and different data systems in primary and secondary care make implementation challenging.
The LFF is a promising initiative and lessons learned are likely to be transferable to other settings as proactive management of frailty takes on greater policy prominence in the UK and worldwide.
英国国民医疗服务体系（NHS）英格兰地区2017 - 18年的全科医疗服务合同规定，英格兰的全科诊所必须积极识别和管理老年人。为响应国家政策，卢顿衰弱框架（LFF）项目应运而生，旨在针对卢顿的老年居民，并根据他们的衰弱程度提供干预措施。本研究的目的是更深入地了解LFF以及影响为不同衰弱程度的老年人提供积极综合护理服务（OPDFL）实施的因素。
我们进行了文献分析，并与利益相关者进行了半结构化访谈，以创建一份“详细描述”，深入了解LFF。
健康老龄化干预措施能带来有益成果，但为了提高其接受度，应与老年人共同制定。初级保健中的通用电子系统和多学科团队会议（MDT）有助于实施。然而，卢顿各地实施情况的差异、对MDT不同程度的接受度以及初级和二级保健中不同的数据系统，使得实施具有挑战性。
LFF是一项很有前景的举措，随着衰弱的积极管理在英国和全球范围内的政策重要性日益凸显，从中吸取的经验教训可能会适用于其他情况。
