Background

Frailty is a condition of increased vulnerability to major changes in health as a result of seemingly small problems, such as an infection or new medication. It is common in older age, affecting around 10% of people aged over 65, and develops because as we get older our bodies change and can lose their inbuilt reserves, for example we lose muscle strength. People with frailty are at increased risk of falls, disability, loneliness, hospitalisation and care home admission. These problems can reduce quality of life and are costly for the NHS and social care.

We have received £2.7 million of funding from the National Institute for Health and Care Research to develop and test a new type of care which aims to improve the quality of life for older people with frailty by giving them choice and control over decisions about their own health and wellbeing.

The new type of care, called personalised care planning, is designed to improve self-management skills and help older people with frailty to improve their wellbeing and thrive with the support of their community. This approach also aims to improve coordination of GP, voluntary sector and social care services and increase the social networks of older people with frailty.

PROSPER Tree graphic

Aims & Objectives

The overall aim of this five year research programme is to find out whether personalised care planning improves quality of life for older people living with frailty, and is cost-effective.

Methods

To answer these questions we plan four work packages (WP):
WP 1: Refining the target population by exploring health and social care resource use in frailty
We will use a validated electronic frailty index (eFI) to study health and social care resource and quality of life
data to refine the target population for personalised care planning, and model resource use.
WP 2: Optimising personalised care planning for older people with frailty
We will optimise the design and implementation of personalised care planning by building on the existing Age UK integrated care
service and refining a personalised care planning logic model so that the intervention is relevant to the needs of older people with
frailty and aligned with service resources.
WP 3: Feasibility study
We will establish feasibility of a cluster randomised controlled trial evaluation of personalised care planning in frailty.
WP 4: Definitive trial
We will evaluate the clinical and cost-effectiveness of personalised care planning for older people with frailty in a multi-site cluster
randomised controlled trial.

In the work to date the team have identified which people would most benefit from personalised care planning by studying how quality of life and use of health and social care services changes as frailty develops. Following a successful feasibility study they have now refined the intervention and are testing the personalised care planning approach in a population of 1337 across Yorkshire and the North West of England.

Outputs

Kime N, Wright A, Heaven A, Hawkins R, Smith J, Cundill B, Foy R, Lawton R, Farrin A, Hulme C, Clegg A. Implementing personalised care planning for older people with frailty: a process evaluation of the PROSPER feasibility trial. BMC Geriatrics 2022; 22(760). https://doi.org/10.1186/s12877-022-03426-4

Heaven A, Bower B, Cundill B, Farrin A, Foster M, Foy R, Hartley S, Hawkins R, Hulme C, Humphrey S, Lawton R, Parker C, Pendleton N, West R, Young J, Clegg A. Study protocol for a cluster randomised controlled feasibility trial evaluating personalised care planning for older people with frailty: PROSPER V2 27/11/18. Pilot and Feasibility Studies 2020;6:56. https://doi.org/10.1186/s40814-020-00598-x

Partners & Collaborators

Investigators
Clegg A, Young J, Bower P, Cundill B, Farrin A, Foster M, Foy R, Hartley S, Hawkins R, Hulme C, Lawton R, Humphrey S, Pendleton N, West R, Holmes J.

Collaborators
The Research team is led by Dr Clegg at the Academic Unit for Ageing and Stroke Research, and includes experts from the Clinical Trials Research Unit (CTRU) at Leeds Institute of Clinical Trials Research (LICTR), the Academic Unit of Health Economics at the Leeds Institute of Health Sciences (LIHS), the Academic Unit of Primary Care at LIHS, and the University of Leeds School of Psychology, who are working in partnership with Age UK, the University of Manchester, a GP representative from Bradford District and City Clinical Commissioning Groups, TPP and members of the public.

Timescales

October 2018 – May 2025

Funding agency

National Institute for Health and Care Research (NIHR)

Further information

For further information contact Professor Andrew Clegg – Chief Investigator or  Anne Heaven – Programme Manager  Telephone: 01274 382815

This summary presents independent research funded by the National Institute for Health and Care Research (NIHR) under the NIHR Programme Grant for Applied Research (PGfAR)  Award, reference RP-PG-0216-20003. Personalised Care Planning for Older People with Frailty. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.