Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to integrate frailty assessments into cancer care pathways for older patients within the NHS.

The Department has several mechanisms in place to monitor and evaluate the implementation and effectiveness of frailty assessments for older cancer patients. The GP contract requires all practices to take steps each year to identify any registered patient aged 65 and over who is living with moderate to severe frailty. Where a patient, including those with cancer, is identified with severe frailty, the practice must undertake a clinical review, including an annual medication review, and provide the patient with any other clinically appropriate interventions (i.e. blood tests and further examinations or referrals).

In addition, practices must ensure that each of its registered patients aged over 75 years old are assigned a named general practitioner, who is required to respond to the patient’s needs in a timely manner, including undertaking clinical reviews and ensuring that the patient receives an annual health check if requested.

Developed through collaboration between a wide range of health and social care organisations, professionals and subject matter experts, NHS England recently published Proactive care: Providing care and support for people living at home with moderate or severe frailty guidance in an online-only format for integrated care boards and provider organisations involved in the design and delivery of proactive care. The guidance aims to support a more consistent approach to proactive care across England for people living at home with moderate or severe frailty, in line with the latest evidence and best practice. A proactive care approach can improve people’s health outcomes and their experiences of healthcare by slowing the onset or progression of frailty and enabling people to live independently for longer.

This Department and NHS England are committed to improving access to community oncology services by moving towards a Neighbourhood Health Service, with more care delivered in local communities to spot problems earlier. This includes maximising the pace of roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing community diagnostic centres (CDCs) and ensuring timely implementation of new CDC locations and upgrades to existing CDCs, with capacity prioritised for cancer diagnostics.