The Frailty Academy: Transforming Quality of Care for Older People Through a Comprehensive, Interdisciplinary, Whole-System Education and Training Programme

Background: Older people living with frailty are at higher risk of harm from fragmented, uncoordinated care, yet formal frailty training is not routinely provided across the workforce. The Frailty Academy was established within Surrey Heartlands Integrated Care System (ICS) to address this patient safety challenge by equipping health and care professionals with the knowledge, skills, and confidence to deliver safe, person-centred care. Its ambition is to transform workforce culture and capability, embedding frailty awareness, leadership, and clinical expertise at scale across all sectors.

 

Approach: The Academy provides a system-wide, tiered education framework aligned with the Skills for Health Frailty Core Capabilities Framework. It was co-designed with clinicians, educators, the voluntary sector, and people with lived experience.

- Tier 1: Universal frailty awareness for all staff and community members (including older people themselves) via e-learning, workshops, and a Train-the-Trainer model.

- Tier 2: A Frailty Champions programme with webinars, multidisciplinary masterclasses, and peer-led training.

- Tier 3: Specialist education for Advanced Clinical Practitioners and Specialty Doctors, including simulation, governance, and Quality Improvement (QI) training.

 

Innovative workforce models include Educational Fellowships for Allied Health Professionals, Adult Social Care, and the Voluntary Sector - embedding leadership, education, and QI skills. Fellows have driven system change projects, including training for unregistered carers and therapy integration across the frailty pathway. Frailty education has also been embedded into undergraduate and postgraduate curricula at the University of Surrey, in order to educate the practitioners of tomorrow.

Governance is provided through a multi-agency steering group with representation from academia, clinical leaders, and community partners. Continuous evaluation, feedback loops, and alignment with the NHS Long Term Workforce and Ten Year plans.

 

Results: The Frailty Academy has trained over 6,000 staff across all sectors. Through education and training the integrated pathway has significantly improved the flow of older people:

- 22% reduction in hospital length of stay for older people.

- 45% reduction in 30-day readmissions for over-85s.

- 59% reduction in surgical outliers

- Improvement in Urgent Community Response two-hour compliance from 40% to 82%.

- 83% of Tier 1 participants reported significant improvement in knowledge; 100% of Tier 2 attendees rated the course "Excellent" or "Very Good."

 

Cultural and qualitative outcomes include improved interdisciplinary collaboration, proactive risk identification, and increased confidence to apply Comprehensive Geriatric Assessment and frailty scoring in daily practice. New portfolio roles (e.g., enhanced frailty practitioners with frailty expertise) are improving recruitment and retention while embedding leadership at every level.

 

Implications: The Frailty Academy demonstrates how large-scale, clinically led education can strengthen system capability, reduce harm, and improve outcomes for older people. By combining workforce development, quality improvement, and co-production, the Academy has created a sustainable model that builds local capacity and resilience. Its integration across acute, community, and voluntary sectors offers transferable learning for health systems globally seeking to address the growing challenge of frailty in the context of an ageing demographic. This blueprint for interdisciplinary education shows that investing in people is the most effective route to safer, more integrated, and person-centred care.