Population health management: pre frailty

Healthwatch Barking & Dagenham undertook two workshops as part of the Population Health pilot in the borough.  The purpose of these workshops was to co-design interventions from the bottom up that would prevent pre-frailty from advancing into actual frailty with people with lived experience.  They spoke to eight people.

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.