BMJ Open · Published 2026-07-01 · DOI 10.1136/bmjopen-2026-116867
Carole Fogg, Tracey England, Martin Vernon, Jane Ball, Lee-Ann Fenge, Peter Griffiths, Francesca Lambert, Abigail Barkham, Sally C Brailsford, Vivienne Windle, Bronagh Walsh
Background Frailty is a common condition in older adults which becomes more prevalent and more severe with age. Health and care services designed to meet the needs of older adults living with frailty are expanding in number and scope, but information on the workforce needed to deliver services both now and in the future is lacking.Objectives To understand the service design and staffing configurations for frailty services through gathering data on the setting and purpose of services; target population; referral methods into the service; specific activities delivered; frailty assessment tools; key service and patient outcomes; staff involved; future service priorities and anticipated future workforce requirements.Design National survey, circulated electronically via national networks and organisations involved in the care of patients with frailty (n=26).Setting England health and care settings.Participants Health and care professionals delivering services for people living with frailty.Results There were 93 survey responses from frailty services across England, of which 82 contained usable information. Respondents included clinicians and managers in a range of health and care sectors and the voluntary sector. Frailty services across settings commonly prioritised reducing frailty-associated risks but few focused on prevention. Staff teams included representation across professions, with specialists in older people’s care (eg, geriatricians, advanced practitioners) present in most teams, but non-specialist team members (eg, therapists, social workers and care co-ordinators) comprised a large proportion of the total workforce. All respondents identified similar priorities for their service in future, including reducing frailty progression, and specified needs for additional staff which broadly reflected the current team configurations. However, staff vacancies or unmet patient need due to low capacity was highlighted, and all respondents identified the need for additional staff in future.Conclusions Services designed to identify and manage people with frailty are complex and require a workforce with specialist training to assess, plan and deliver care. Current services are understaffed with insufficient capability to prevent frailty onset or slow progression, thereby failing to address unmet need. Workforce planning and resourcing to address frailty-related needs is urgently required.
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Fogg, C., England, T., Vernon, M., et al. (2026). What are the characteristics of the health and care workforce supporting people living with frailty in England now and what is needed for the future? A national survey. BMJ Open. https://doi.org/10.1136/bmjopen-2026-116867