Living Well With Frailty: Conference Outputs

The Living well with Frailty event, held at Heriot-Watt University in Edinburgh on the 27th of October brought together colleagues from across the health and social care sector to undertake a deep dive into the issues surrounding frailty.

The day comprised morning and afternoon plenaries, as well as eight breakout sessions ranging from ‘A focus on Dementia – personal outcomes in practice?’ to ‘Care Homes: My care, Your care, Our care – Designing a Care Home for the future’. For a full list of the sessions please download a copy of the agenda from the day. A comprehensive overview of each of the sessions is available below.

Breakout sessions
Timely identification and co-ordination of care for older people living with frailty
Presenters: Penny Bond and Karen Goudie

During this workshop, Karen and Penny from Healthcare Improvement Scotland led a discussion with attendees on what it means to be an older person with frailty going through our hospital system. Brief patient stories were shared to highlight opportunities and challenges as a starting point for discussion. Attendees then shared experience of testing and implementing different approaches to identifying and coordinating frailty care within acute care settings. The timely identification and co-ordination of care for older people living with frailty presentation can be viewed via the following link and you can watch a video of Mrs Andrews’ story on YouTube below.

Focus on Dementia: Personal outcomes in practice
Presenters: Amanda Johnson and Douglas Philips

This interactive session, presented by Amanda and Douglas from the Focus on Dementia team at the Scottish Government, allowed health and social care practitioners to come together to:

  • hear about the Focus on Dementia work programme and the Essential 5 criteria, and how this can be implemented to improve the quality of personalised outcome planning
  • hear carer, individual and professional perspectives and share learning from existing approaches to person-centred planning across settings, and
  • identify actions for implementation in local areas using an improvement approach.

A series of questions were asked during the session, and these we used to frame the session. A video of the session is available to watch, and you can also download a copy of the presentation, Focus on Dementia – changing minds, improving lives in Scotland

Hospital at Home
Presenters: Anne Hendry, Trudi Marshall and Angie Wilkinson

Anne from the Joint Improvement Team led this interactive workshop, which highlighted the progress made in the adoption of Hospital at Home in Scotland. This session also brought to life practical experience of this programme from Trudi and Angie in NHS Lanarkshire and NHS Fife.

Participants explored the critical steps required to develop new models of care at the interface between home and hospital involving practitioners from primary, community and hospital sectors, and working with partners from the third sector, housing and ambulance services. The Hospital at Home presentation and a summary of the workshop are available to download.

Presenters:  Katie McWilliam and Brian Slater 

This workshop, delivered by Katie from the Joint Improvement Team and Brian from the Scottish Government’s Health and Social Care Integration team, provided information on the significant public service reform under way to manage the growing number of people in Scotland who have complex care requirements. Attendees discussed our health and social care system as a whole, specifically joined up care, anticipatory and preventative care and community-based care.

We created a padletan online sheet of paper to record the session discussions, as well as the presentation, Ready… Steady… Commission, for you to view.

Living and Dying Well with Frailty 
Presenters: Mark Hazelwood, Anna Lloyd and Ranald Mair

This workshop, presented by Mark from the Scottish Partnership for Palliative Care and Anna and Ranald from Scottish Care, explored palliative and end of life care in the context of frail older people. Participants had an opportunity to:

  • discuss key concepts and challenges in palliative and end of life care
  • reflect on how these related to their own professional and organisational circumstances, and
  • share perspectives (either professional or personal), experiences and learning about supporting people with frailty to live and die well.

Key areas discussed were: identifying who has palliative care needs; uncertainty; and communication.

A presentation of the session, Living and Dying Well with Frailty, is available, as well as a case study of Mrs Howie and discussion prompt sheet which was used to identify some of the issues faced by Mrs Howie.

Polypharmacy – a call to action
Presenters: Simon Hurding and David Binyon

In this workshop Simon and David from the Scottish Government used the Polypharmacy Guidance 2015 to provide structure to the discussion. It aimed to build an understanding of the difference between appropriate and inappropriate polypharmacy and how to define frailty.

The polypharmacy – a call to action presentation is available to view here and a copy of the padlet is also available.

My Care, Your Care, Our Care: Designing a Care Home for the Future 
Presenters: Margaret McKeith and Rene Rigby

During this workshop, Margaret and Rene from Scottish Care led participants to design the care home that they felt will be fit for future generations. The physical environment, technology, the workforce, the services and the culture within that care home were all considered.

The presentation, My Care, Your Care, Our Care: Designing a Care Home for the Future, can be downloaded and a video of the session can be viewed.

Falls and Frailty in the community 
Presenters: Ann Murray, Christine McArthur, Elaine Jamieson

Ann, Christine and Elaine from NHS Highland held a workshop that generated lots of discussion on unscheduled care, falls and frailty pathways in the community and the factors that contribute to a successful pathway. Delegates also discussed:

  • what it means to be an older person receiving Scottish Ambulance Service support following a fall
  • NHS Highland’s experience of introducing a Scottish Ambulance Service falls and frailty pathway, and
  • where we are in Scotland in terms of implementing Scottish Ambulance Service Pathways for falls and frailty.

A copy of the Falls and Frailty in the Community presentation is available to view. The team has also put together a report of the outputs from the session.



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