Care England Highlights Frailty Crisis Demands Urgent Action, Investment, and a National Strategy in the Wake of NAO Report

Care England has responded to the National Audit Office’s new report, Primary and community healthcare support for people living with frailty, which reveals long-standing and systemic pressures affecting the support older people receive in the community, particularly the lack of consistent NHS provision around frailty identification, follow-up, rehabilitation and prevention.

The NAO report highlights that frailty affects at least 1.5 million older people, at an estimated annual cost of £5.8 billion to the healthcare system, yet national systems for early identification, follow-up care, and community-based support remain inconsistent and fragmented. Importantly, the report makes clear that these shortcomings sit within health system structures, not within care homes themselves.

Professor Martin Green OBE, Chief Executive of Care England, said:

“This report reinforces what providers have experienced for many years: care homes are ready and willing to deliver preventative, rehabilitative, movement-based support, but the national framework around frailty is incomplete. We urgently need a coherent national frailty strategy, proper investment in community health services, and a shift toward prevention aligned to the NHS 10-year plan. Care homes cannot do this alone. We need primary care, community services and social care properly aligned so older people get the proactive support they deserve.”

Care England emphasised that adult social care staff work tirelessly to support people living with frailty, but the NAO’s findings show that years of underfunding, limited access to community therapies, and inconsistent NHS support models have left gaps that no single part of the system can bridge alone.

Rather than framing frailty as inevitable, Care England highlighted that structured movement, stability programmes and personalised activity, such as those implemented in its collaborative work with Be Great Fitness and NHS partners, demonstrate that frailty can be delayed, reduced or even reversed.

Bailey Greetham-Clark, Founder of Be Great Fitness, added:

“Frailty is not a fixed trajectory. Our work in care homes shows that with consistent, personalised movement support, residents regain strength, confidence and independence, often far beyond what was thought possible. These programmes reduce falls, stabilise health and improve wellbeing. With the right investment, this approach could transform outcomes nationally.”

Care England welcomed the NAO’s recognition that the current approach lacks a unified strategy, consistent oversight and sufficiently funded community services. The sector now needs government to act decisively.

Professor Green continues:

“This report must be a turning point. The cost of frailty, financially, socially and in human terms, is too great to ignore. Government must invest in community-based prevention, rehabilitation and social care capacity. Providers across England are already demonstrating what works. Now we need national backing to scale it.”

Care England is calling for:

• A national frailty strategy aligned across DHSC, NHS England and adult social care
• Investment in preventative, movement-led approaches proven to reverse decline
• Stronger community services, including therapy, falls prevention and rapid support
• Recognition that social care is essential infrastructure in tackling frailty

The organisation emphasised that care homes are not the cause of system failure, they are central to the solution, and they stand ready to scale evidence-based programmes that deliver measurable improvements for older people.