The report Primary and Community Healthcare Support for People Living with Frailty (National Audit Office) found that 1.51 million people had been diagnosed by their GP as living with moderate or severe frailty as at March 2025. People living with severe frailty are nearly 6 times more likely to be admitted to hospital than those not living with frailty.
Frailty is a clinically recognised medical condition related to the ageing process, in which multiple body systems gradually lose their in-built reserves. People living with frailty typically walk slowly, become exhausted easily and struggle to get out of a chair or climb stairs. They are more likely to be housebound, or only able to leave their home with help. Frailty typically takes five to ten years to develop, and there is often a slow decline of function. Older people with mild, moderate or severe frailty often come to the attention of healthcare professionals when in crisis (for example, going to A&E after a fall). The NHS recognises that, like most other long-term conditions, frailty can be effectively managed within primary care and other community-based services.
The prevalence of frailty is likely to increase as the population ages.
Frailty is more common in women than in men. Those from lower socio-economic groups are more likely to develop frailty and more likely to become frail earlier in life.
However, the National Audit Office report concludes that an early diagnosis of frailty, along with the right support, can slow its progression and delay the loss of independence, enabling older people to live longer and healthier lives.
GPs are required to identify any registered patient aged 65 years or over who is living with moderate or severe frailty. Tools such as the electronic frailty index (‘the index’) help to identify people at risk of living with frailty. The index uses existing information within the electronic primary healthcare record to identify people who may be living with varying degrees of frailty. When the index identifies someone at risk of living with frailty, NHS England guidance is that GPs should use direct clinical assessment and judgment to confirm if that person has frailty.
Once a patient has been diagnosed with severe frailty, GPs are required to carry out a clinical review, which includes:
Community health services that are relevant to frailty are wide-ranging, and include urgent community response, district nursing, and falls prevention services. For people living with frailty, these services offer important support to help them live independently for longer.
NICE Guidance Dementia, Disability and Frailty in Later Life – Mid-life Approaches to Delay or Prevent Onset includes recommendations on promoting a healthy lifestyle to reduce the risk of, or delay the onset of, frailty by helping people to:
This approach is also helpful to help reduce the extent and impact of existing frailty.
Falls are the main cause of a person losing their independence and needing to go into long term care. After a fall, the fear of falling can lead to more inactivity, loss of strength and loss of confidence. Falls prevention work is, therefore, an important part of managing, and helping to delay the onset of, frailty. Age UK provides advice on Preventing Falls. The National Institute for Health and Care Excellence (NICE) guidelines related to frailty specify that any adult living with frailty who has fallen in the past year should be offered a comprehensive falls risk assessment and comprehensive falls management support.
The NHS England website contains links to resources intended to help address the common ‘frailty syndromes’ of falls, immobility, delirium, incontinence and side effects of medication.
