Frailty360 is an innovative frailty training programme which uses a unique set of resources and an immersive approach to education to deliver key learning objectives in frailty and integrated person-centred care.

A brief history

In 2015, health and social care workforce leaders in Nottinghamshire commissioned Fusion48, in partnership with the Primary Care Development Centre to develop the Frailty & Supported Self-Care Toolkit and training programme.

The initial focus of the programme was:

  • Enabling supported self-care;
  • Integrated assessment;
  • Multi-professional and multi-agency learning and working;
  • Consistent education and training standards;
  • Promoting learning through innovation.

The training and toolkit were shaped by older people with frailty and professionals, through:

  • Multi-professional, cross-organisational ‘Expert Advisory Panel’ and ‘User Group’, including local stakeholders and external experts
  • A small group of older people with frailty, their families and carers.

The initial programme received excellent feedback and achieved a 33% increase in participant’s understanding of frailty and a 27% increase in confidence in supporting older people to self-care in follow up evaluation.  This included senior and experienced cohorts.

Developments

The programme and associated resources have continued to evolve based on extensive feedback from over 2,000 participants from hundreds of different organisations across all sectors of health, social care as well as the wider public and voluntary sectors.

The content of programme has also been extended and further developed to reflect deployment across a range of settings and local areas in the North West, North East, Midlands, South Coast and London.

The programme has also incorporated new national guidance and evidence, including NICE guidance on Multimorbidity, the introduction of Routine Frailty Management into the Core GP Contract, and NIHR evidence reviews.

During early 2018, further updates have been made to align with the HEE/Skills for Health Frailty Framework of Core Capabilities which references the Toolkit as a “Current relevant resource” and has been shaped by the innovative resources developed as part of the programme.

Key innovations

Frailty Fulcrum

Fusion48’s Frailty Fulcrum is a multi-dimensional model which highlights the importance of balancing vulnerabilities with sources of resilience.  It has been developed as an animation and featured in a guest blog by Dr Dawn Moody for NHS England https://www.england.nhs.uk/blog/dawn-moody/

FrailtySIM – the virtual reality frailty experience

FrailtySIM has also been developed from initial prototype to a complete immersive learning experience through funding from Ufi Charitable Trust as a Voctech 2016 project https://www.ufi.co.uk/projects/voctech-seed-projects-2016

FrailtySIM is now available on both App Store and Google Play Store.  The learning resources can be found in relevant modules or from the Frailty360 website.

Frailty Toolkit

The Toolkit is a web-based application designed to  provide quick and easy access to a range of frailty-related resources.  It brings together learning resources with practical guides and tools and has a section for localised Directory of Resources.

Underpinning principles

In addition to the innovations of the Frailty Fulcrum, FrailtySIM and the Frailty Toolkit, there are three underpinning principles that Frailty360 promotes: Person-centred approaches; Maximising and supporting an individual’s independence; and Multi-disciplinary integrated working.

Person-centred approaches

The real-life stories of Nirmala, Baldev and Victor are used to enhance understanding and enable participants to apply their knowledge and analyse relevant situations and scenarios.

Further case studies support specific elements of the training, whilst participants are also encouraged to apply the tools to their own case examples or current situations.

Maximising and supporting an individual’s independence

The Supporting Independence Care Planning template provides a structured approach to understanding what is important to the individual and then exploring what is helping them as well as getting in the way of the person doing what they would like to be able to do.  Taking a positive ‘can do’ strengths-based approach it encourages those involved in supporting older people living with frailty to apply the principles of empowerment, motivation and capability, whilst also exploring the full range of local capacity to support the person (including family, friends, local community).

Multi-disciplinary integrated working

The vast majority of the training has been delivered to multi-disciplinary groups, with participants frequently coming from different local organisations.  The design of the sessions aims to encourage collaboration and integrated working, as well as providing opportunities for individuals with different backgrounds to network and gain insight into other parts of their health and care systems.

Whilst the training will benefit single discipline teams from one organisation, the impact is greatest when events are run with more diverse groups.

Local Champions & Trainers

Initially established as part of the Nottinghamshire programme the Local Champions and Trainers approach has since benefited from substantial further development to ensure continued alignment with the latest national developments in frailty policy and practice, and to enable it to meet the needs of wide range of organisations and geographies.

By March 2018 there were over 200 “Local Trainers” from a wide range of organisations and geographies with access to the core resources to enable the training to be cascaded.

In addition to receiving familiarisation training, Local Champions & Trainers are provided with both physical and digital training resources to deploy flexibly based on the needs of the individuals undertaking the cascade training.

Module resources include PowerPoint slides complete with speaker notes; videos or other animations; exercise cards or instructions; and answer sheets and templates.  The Modules use a range of learning styles from high tech Virtual Reality to low tech role play cards.  The aim throughout is to use interactive and immersive approaches to learning, ideally carried out in Multi-Disciplinary Teams.

The current modules can be accessed in the Facilitator Resources section of the Toolkit or via the links below.  There are also some tips for cascading the training available.

Module 1: Introductory Quiz

Module 2: Understanding Frailty

Module 3: Identifying Frailty

Module 4: Managing Frailty Overview

Module 5: Supporting Independence & Person-Centred Care

Module 6: FrailtySIM – Become Victor & Being Jane

Module 7: FrailtySIM – Walking through Frailty

Module 8: Victor’s story

Module 9: Nirmala’s Multi-Disciplinary Team

Module 10: Caring for the carers – Baldev’s story

Module 11: Adapting to live well with frailty – Nirmala & Baldev together

Module 12: Introduction to the Frailty Toolkit

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