Population Health Management: Pre-Frailty

This report presents a summary of the findings from 2 workshops run by Healthwatch Barking and Dagenham as a part of the Population Health Pilot in the borough. The aim of these workshops was to design interventions from the bottom up that would prevent the pre-frailty from advancing into actual frailty with these interventions being proposed and designed by the cohort themselves. Participants were drawn from a cohort of those identified as pre-frail in the borough, and particularly those aged over 50 and diagnosed with hypertension. The outcomes from these workshops, along with suggestions for improving future levels of engagement, are presented here under thematic headings requested by NHS North East London:

Firstly, participants were able to articulate very clearly the big barriers and smaller hurdles that stop them, or slow them, from accessing healthcare. None of these barriers or hurdles were new, but the consistent articulation of them suggests that they should be taken into account when planning future works. Mitigating for language barriers, a lack of understanding of NHS systems and the online/offline divide will be key to involving patients in planning their own services and consulting with them around these.

Secondly, it is likely no coincidence that 3 of the 4 patient designed interventions independently proposed the creation of a virtuous circle whereby the NHS make it easier people to make positive choices about their healthcare and lifestyle which leads to people doing more and better things for themselves. Kicking off this positive loop should feature prominently in planning in the borough for slowing or stopping the move from pre-frailty to frailty. Similarly, 2 of the 4 participant designed interventions recognise that not all cohorts of patients are the same and call for specialist provision and allocations for those with the greatest need. If building resilience against frailty is a health priority in the borough, then prioritising and working with those in danger of becoming frail is an obvious first step.

Finally, though the desire to engage with patients and to have them playing an active role in designing health interventions in the borough is both admirable and genuine, there are challenges in getting patients around the table to engage. It is hoped, and recommended, that the suggestions for widening engagement listed in Section 4 of this report are acted upon. Building grassroots engagement from scratch, or a very low level, is a huge task and, where possible, NHS North East London should look to work with trusted community, voluntary and faith sector groups to reach patients and residents in as wide a variety of ways as is possible and practicable.