Frailty Improvement Programme

Supporting health and social care staff to improve the experience and outcomes of people with frailty, their carers and families.

We support improvement work across all services and settings with a focus on integration. Our work draws on the learning from the Frailty at the Front Door Collaborative and Living and Dying Well from Frailty Collaborative.

We are currently focusing on:

  • Focus on Frailty programme
  • Frailty learning system​


Focus on Frailty

Healthcare Improvement Scotland is currently recruiting teams to join the Focus on Frailty programme. The programme will help teams make improvements to services accessed by people living with, or at risk of living with frailty. The programme brings together:

  • NHS boards
  • health and social care partnerships
  • GP practices, and
  • the third and independent sector.

Teams will gain access to:

  • learning sessions
  • quality improvement coaching, and
  • data and measurement expertise.

The programme is supported by an evidence-based package of frailty support. Frailty professionals from across disciplines, sectors and regions helped co-design this package. Organisations and individuals with a focus on lived, and living, experience also contributed. It builds on Healthcare Improvement Scotland’s 90 day learning cycle on frailty.

To join the Focus on Frailty programme, download the application form. Guidance on how to apply to the Focus on Frailty programme is also available to download. Further information is available on the Focus on Frailty web pages.


Frailty Learning System

Enabling staff and teams to share and learn from each other.

Our Frailty Learning System is open to anyone working in healthcare, social care, voluntary and independent sectors across Scotland. It provides a range of engagement and learning opportunities which include:

  • Webinars: learn about national and local improvement work, ask questions and feed into discussions.
  • Frailty Resources: view a range of tools and resources you can use to help improve outcomes for people living with frailty, along with case studies from health and social care teams. We have produced two case studies, the first with the Queen Elizabeth University Hospital in Greater Glasgow and Clyde on their experience with the Frailty at the Front Door collaborative and the further tests of change they did following that. Our second case study was with Charlie Chung of Fife Health and Social Care Partnership looking at their community health and wellbeing hubs.
  • An online platform: communicate, share information and ideas with staff across Scotland who are interested in improving services for people with frailty. Input and influence the design of the ihubs improvement offer.

Join the Frailty Learning System by following this link to MS Teams or emailing


Frailty 90 Day Learning Cycle

Our ihub frailty team has completed a 90 Day Learning Cycle in 2021 during the COVID-19 pandemic, whilst frailty services remained operational.

The 90 Day Learning Cycle focused on answering the question “How can the ihub enable the health and social care system to better understand their integrated approach to the delivery of frailty services?”

To achieve this, the team applied the principles of a 90 Day Learning Cycle methodology. This included reviewing the evidence and literature and interviewing a wide range of stakeholders from different roles and organisations.

The 90-Day Cycle has emerged as an invaluable method for rapidly developing innovative approaches to support practice improvement. Generally, 90-Day Cycles are a disciplined and structured form of inquiry designed to produce and test knowledge syntheses or prototyped processes or products in support of improvement work." Carnegie Foundation, 90 Day Cycle Handbook

This work supported the team to:

  • explore frailty services in Scotland, 
  • identify key components that enable successful integrated working, and  
  • highlight examples of integrated multidisciplinary working to identify and support people living with frailty.

The report from the 90 Day Learning Cycle presents findings which have established seven key components of an integrated frailty system across health social care and the independent and third sector. The report sets out the next steps for the ihub Frailty Improvement and Implementation Programme which will be launched later in 2022.

We would like to thank all those who contributed to this work and we look forward to continuing to work together as we co-design the new ihub Frailty Improvement and Implementation Programme.

You can read the report here: Improving care and support for people living with frailty in Scotland (May 2022).

If you would like more information please contact