79th Report - Supporting people with frailty outside hospitals
Select Committee
Public Accounts Committee
HC 1706
3 June 2026
Government Response (AI assessment · 7 of 23 classified)
Recommendations & Conclusions
23 results
2
Recommendation
Not Addressed
NHS England is not reducing the unacceptable variation in support for people with frailty across...
Recommendation
NHS England is not reducing the unacceptable variation in support for people with frailty across and within Integrated Care Boards (ICBs). There is significant and unexplained regional variation between areas – 32 out of 106 local NHS areas assessed less …
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Government Response Summary
The government states it agrees with the recommendation but then provides a response entirely focused on net zero, innovation funding, and a Net Zero Innovation Board, which bears no relevance to the committee's specific recommendation about NHS England and frailty.
HM Treasury
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3
Recommendation
Not Addressed
NHS England’s existing oversight arrangements are not improving GPs’ assessment and support of people with...
Recommendation
NHS England’s existing oversight arrangements are not improving GPs’ assessment and support of people with frailty. It is not clear exactly who is responsible for improving performance. NHSE considers that ICBs are responsible for commissioning services to meet the needs …
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Government Response Summary
The government stated it agreed with the recommendation but then discussed initiatives related to green choices, energy efficiency, and zero-emission vehicles, failing to address how new accountability arrangements would improve GP assessment and support for people with frailty.
HM Treasury
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4
Recommendation
Not Addressed
NHS England has overloaded GPs, who have limited capacity, with new and expanding priorities.
Recommendation
NHS England has overloaded GPs, who have limited capacity, with new and expanding priorities. NHSE has prioritised improving patients’ access and digital access to general practice. It recognises that pushing to improve one aspect of care inevitably causes consequences to …
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Government Response Summary
The government stated it agreed with the recommendation but then provided a response detailing cross-government coordination and governance for net zero delivery, failing to address GP capacity, impact assessments for new priorities, or how neighbourhood health teams will share responsibilities for frailty.
HM Treasury
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5
Recommendation
Not Addressed
The frailty policy landscape is confusing and fragmented.
Recommendation
The frailty policy landscape is confusing and fragmented. NHSE and the Department are planning and developing several frailty specific initiatives, such as a national frailty dashboard, and a Modern Service Framework for frailty and dementia. There are also a number …
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Government Response Summary
The government agreed with the recommendation but provided a response focused on the net zero research and innovation portfolio and a list of past Treasury Minutes, offering no specific commitment to provide an update on frailty policy interaction.
HM Treasury
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6
Recommendation
Not Addressed
We remain deeply concerned that cuts to ICBs are insufficiently thought through and will undermine...
Recommendation
We remain deeply concerned that cuts to ICBs are insufficiently thought through and will undermine their ability and capacity to carry out their functions. It is unclear what oversight roles ICBs will retain under NHSE’s plans to make them into …
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Government Response Summary
The government stated it agrees with the recommendation but then provided a response entirely focused on the net zero research and innovation portfolio, failing to address the committee's concerns about ICB cost reductions or provide reassurances from DHSC and NHSE.
HM Treasury
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1
Conclusion
Not Addressed
On the basis of a report by the Comptroller and Auditor General, we took evidence...
Conclusion
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department) and from NHS England (NHSE).1
Government Response Summary
The government stated it agreed and that the recommendation was implemented, but then provided a response detailing funding for net zero initiatives, which is irrelevant to the committee's statement about taking evidence from DHSC and NHS England.
HM Treasury
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7
Conclusion
Not Addressed
For all patients diagnosed with severe frailty, the GP contract requires GPs to do a...
Conclusion
For all patients diagnosed with severe frailty, the GP contract requires GPs to do a clinical review. This includes a review of the patient’s medication, a falls risk assessment and a discussion with the patient of the benefits of having …
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Government Response Summary
The government stated it agreed with the recommendation but then discussed the 'Framework Delivery Plan' and provided a long list of past Treasury Minutes, failing to address the committee's observations on GP frailty assessments and support.
HM Treasury
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8
Conclusion
NHSE pointed to the large proportion of people with severe frailty living in care homes...
Conclusion
NHSE pointed to the large proportion of people with severe frailty living in care homes and how it expected primary care networks to provide support such as weekly ward rounds.14 NHSE recognised that this care needed 8 Q 2 9 …
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HM Treasury
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9
Conclusion
In 2024–25, 32 of 106 local NHS areas (known as sub-ICBs) assessed less than 10%...
Conclusion
In 2024–25, 32 of 106 local NHS areas (known as sub-ICBs) assessed less than 10% of their registered patients aged 65 or over. However, nine of 106 local areas assessed 90% or more of this group of people, suggesting that …
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HM Treasury
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10
Conclusion
NHSE acknowledged the scale of variation and that tackling variation was one way it was...
Conclusion
NHSE acknowledged the scale of variation and that tackling variation was one way it was trying to improve performance overall.20 NHSE told us that the reasons for variation will be different in different places. For example, some areas may have …
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HM Treasury
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11
Conclusion
NHSE also highlighted variation in terms of the range of community services across the country...
Conclusion
NHSE also highlighted variation in terms of the range of community services across the country that are not specified or described clearly or consistently. It explained that these services are coded, measured and counted in different ways and often funded …
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HM Treasury
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12
Conclusion
NHSE has set requirements for ICBs and GPs to provide health services that aim to...
Conclusion
NHSE has set requirements for ICBs and GPs to provide health services that aim to assess and support people living with moderate and severe frailty.25 NHSE considers that ICBs are responsible for managing and measuring performance of many of the …
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HM Treasury
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13
Conclusion
NHSE told us that it is working to improve accountability and that, in the future,...
Conclusion
NHSE told us that it is working to improve accountability and that, in the future, it intends to hold ICBs to account for commissioning against the modern service framework and expects there will be data from its national frailty dashboard …
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HM Treasury
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14
Conclusion
NHSE also told us that it was about to write to ICBs, as part of...
Conclusion
NHSE also told us that it was about to write to ICBs, as part of the framework for neighbourhood health, with the key requirements that ICBs need to have in place next year around enabling better, more appropriate care for …
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HM Treasury
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15
Conclusion
We were concerned that GPs might not be prioritising care for those with or at...
Conclusion
We were concerned that GPs might not be prioritising care for those with or at risk of frailty. NHSE acknowledged that GPs were not formally assessing enough of their patients for frailty.32 NHSE recognised that it had pushed GP practices …
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HM Treasury
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16
Conclusion
NHSE was clear that the “ position we are in is not acceptable”.34 The Chief...
Conclusion
NHSE was clear that the “ position we are in is not acceptable”.34 The Chief Medical Officer also explained that to understand GPs’ capacity, it is important to factor in geographic or demographic pressures. These could include rural or peripheral …
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HM Treasury
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17
Conclusion
NHSE told us that it is looking at interventions that could be done by other...
Conclusion
NHSE told us that it is looking at interventions that could be done by other health care professionals in primary care. For example, enhancing the clinical service community pharmacists provide to include undertaking medication reviews for people with frailty.36 However, …
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HM Treasury
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18
Conclusion
NHSE has put in place multiple initiatives that aim to help with frailty.
Conclusion
NHSE has put in place multiple initiatives that aim to help with frailty. It has set requirements for ICBs and GPs to provide health services that aim to assess and support people living with moderate and severe frailty. They include …
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HM Treasury
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19
Conclusion
NHSE informed us that it was establishing a national frailty dashboard which will take into...
Conclusion
NHSE informed us that it was establishing a national frailty dashboard which will take into account the range of interventions that NHSE expects ICBs to have in place. It noted that it does not intend to publish what it considered …
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HM Treasury
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20
Conclusion
NHSE informed us that there are also a number of broader developments which may affect...
Conclusion
NHSE informed us that there are also a number of broader developments which may affect service provision for frailty including a forthcoming modern service framework, new funding models for ICBs, a frailty improvement collaborative involving seven sites around the country, …
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HM Treasury
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21
Conclusion
NHSE recognised that it needs more evidence to understand which interventions make a difference for...
Conclusion
NHSE recognised that it needs more evidence to understand which interventions make a difference for patients with frailty and has commissioned a National Institute for Health and Care Research-led evaluation of frailty pathways and interventions.42 Changes to ICBs’ responsibilities
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HM Treasury
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22
Conclusion
In March 2025, the government announced it would abolish NHS England and change the responsibilities...
Conclusion
In March 2025, the government announced it would abolish NHS England and change the responsibilities of ICBs.43 In April 2025, NHSE announced that ICBs had to make 50% cost reductions.44 To achieve this, ICBs are planning large scale redundancies and …
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HM Treasury
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23
Conclusion
We heard of one element of an ICB that currently has 40 people in place...
Conclusion
We heard of one element of an ICB that currently has 40 people in place but which will have one person discharging that responsibility from April 2026. We are not convinced that this reorganisation has been thought through properly and …
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HM Treasury
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