How can we improve Comprehensive Geriatric Assessment for older people living with frailty in primary care and community settings? A qualitative study.

Objective: With advancing age comes the increasing prevalence of frailty and increased risk of adverse outcomes (eg, hospitalisation). Evidence for comprehensive geriatric assessment (CGA), a multidimensional holistic model of care, is mixed in community settings. Uncertainties remain, such as the key components of CGA, who delivers it, and the use of technology.

Equipping the healthcare workforce to meet the complex health needs of older people in the community: a skills-led approach.

The shift towards delivering more clinical care in the community not only supports the healthcare system by avoiding unnecessary hospital admissions, but can also improve outcomes, particularly for older people with complex healthcare needs. Therefore, healthcare organisations need to consider how to ensure their workforce has the capabilities required to provide care in accordance with this new model. This article details a project that involved the design and development of a replicable Ageing Well programme of learning to increase knowledge, skills and confidence among registered and unregistered practitioners, underpinned by a 'skills not roles' strategy.

A nurse-led comprehensive geriatric assessment intervention in primary care: A feasibility cluster randomized controlled trial.

Aim: To determine the feasibility of a nurse-led, primary care-based comprehensive geriatric assessment (CGA) intervention.

Design: A feasibility cluster randomized controlled trial.

Methods: The trial was conducted in six general practices in the United Kingdom from May 2018 to April 2020.

Designing a nurse-led assessment and care planning intervention to support frail older people in primary care: An e-Delphi study.

Aim: To identify and establish expert consensus on important and feasible components of a nurse-led, comprehensive geriatric assessment (CGA)-based intervention for community-dwelling older people who live with frailty.

Design: A three-round modified e-Delphi survey.

Methods: An expert panel of 33 UK specialist older people's, primary and community care nurses participated in the three-round e-Delphi survey over a 12-month period in 2017-2018.

The holistic assessment and care planning in partnership intervention study (HAPPI): A protocol for a feasibility, cluster randomized controlled trial.

Aim: During an initial phase of this research, an e-Delphi survey was conducted to gain consensus among stakeholders on the components of a nurse-led assessment and care planning intervention for older people who live with frailty in primary care. This feasibility randomized controlled trial (fRCT) will test the proposed intervention and its implementation and determine methods for the design of a conclusive randomized controlled trial.

Methods: The fRCT, with embedded qualitative study, aims to recruit 60 participants.

Reframing frailty as a long-term condition.

Frailty is a clinical syndrome that focuses on loss of reserve, energy and wellbeing. Older people with frailty tend to present late and often in crisis to health and care services so their care may be hospital-based, episodic and unplanned. Frailty should be reframed as a long-term condition that can be managed proactively in primary and community settings by supported self-management and person-centred care.

Telehealth enhances self care and independence in people with long term conditions.

The increasing prevalence of long term conditions will influence all nurses' practice, irrespective of their particular field. NHS Cornwall is taking part in a government trial, known as the whole system demonstrator programme, piloting telehealth and telecare to manage long term conditions. This article reports the initial positive results.