A stark report from the government's independent spending watchdog has found that general practitioners are failing to provide adequate care for older people living with frailty across England.
Critical Gaps in Care for the Vulnerable
The National Audit Office (NAO) investigation uncovered significant shortfalls in the identification and management of frailty, a syndrome linked to ageing where the body's systems lose their natural reserves. This condition leads to symptoms like extreme exhaustion and a heightened risk of falls, often leaving individuals housebound.
Despite a requirement for GPs to identify patients aged 65 and over with frailty, only one in six were actually assessed for the condition in the 2024/25 period. This marks a decline from 2017/18, when one in four received an assessment. The report highlights a postcode lottery, with "worrying inconsistency" in support and significant regional variation in assessment rates.
Alarming Statistics on Assessments and Reviews
For those who were diagnosed, the follow-up care was severely lacking. Out of the 226,000 patients identified with frailty in 2024/25, a mere 18% had been assessed for their risk of falling—a major health hazard for this group. Even more concerning, just 16% had received a comprehensive medical review.
Gareth Davies, the head of the NAO, stated it was "crucial that people with frailty are supported effectively and consistently across the country." He emphasised that the report shows many older people are not getting the necessary support and called on the NHS to use its upcoming 10-year plan to build a more sustainable service attuned to the needs of an ageing population.
GP Leaders Point to Workforce and Workload Crisis
In response, GP representatives acknowledged the serious findings but pointed to systemic pressures crippling primary care. Professor Victoria Tzortziou Brown, Chair of the Royal College of General Practitioners, said GPs and their teams are "working under intense and increasing pressures."
She revealed that a fully qualified, full-time GP in England is now responsible for an average of 2,241 patients, a rise of 304 (or 15.7%) per doctor over the past decade. "This is having a serious impact on the time we can spend with our patients and on delivering proactive care," she explained. Professor Tzortziou Brown added that without sufficient workforce and investment, time-intensive aspects like continuity of care, comprehensive assessments, and regular follow-ups are becoming impossible to maintain.
A spokesperson for the Department of Health and Social Care said: "We inherited a situation where too many elderly people had been failed by the health and care system but are working at pace to ensure older people can live well for longer with the care and support they need."
