Author Archives: Tom Gentry

How should we talk about ‘frailty’?

Scene from a care home

In health care, the word ‘frailty’ carries a lot of baggage. In its most positive sense, it is a phrase used by older people’s specialists to describe a particular state of health, usually characterised by multiple or complex physical and mental health and social needs.

This can then be a gateway to proactive care and support joined-up around the individual.

At the less positive end, it is a shorthand for older people in later old age, with multiple long-term conditions that are almost too difficult to manage. In this case the so-called ‘frail elderly’ may be recognised for having high needs but thought of as almost beyond help and given little support.

It is well known that older people do not identify with the word ‘frailty’. This was a strong finding from research we carried out in 2013.

However, we wanted to understand in more detail how older people felt about being referred to as “frail” and whether or not this could impact on their engagement with services. Continue reading

General Election Series: Feeling well


This week’s blog from our General Election Series examines how everyone in later life should have opportunities to enjoy life and feel well. 

The dominant story on older people’s health is often rooted in the view that not feeling unwell is all you can expect as you age. Whatever happened to wanting to feel well?

This may only be a minor linguistic distinction, but it is an important one. This popular perception is partly reflective of how health and care services operate, typically geared to responding to crisis.

Assumption that older age = poor health

But there is also a general fatalism in what health and wellbeing in later life means to people. The likelihood of remaining active and living well into late old age is often underestimated, while the assumption that longer average life expectancy is automatically linked to being in poor health is overestimated. Continue reading

A vision for the NHS

On the 23 October 2014, NHS England published its Five Year Forward View, a vision document for the future of the NHS.

The timing, and the timeline, is very deliberate: this is NHS England’s chief executive, Simon Stevens, setting his stall for next year’s general election.

Whichever party (or parties) form/s the next government will have to decide whether they take this vision on. And whether they are willing to pay for it.

This is a crucial point because Stevens has addressed the enduring taboo of money. Politicians are largely in a state of denial about the funding crisis facing the NHS, forecasted to be short by about £30 billion by 2020/21.

That’s just under a third of the annual budget of the NHS. Stevens is clear: if you want the NHS to continue providing a universal health care service, free at the point of delivery, you cannot escape the fact that more money will need to be found.

For a pre-election period, where more spending, even on the NHS, is avoided like the plague by political parties, this is the very definition of throwing down the gauntlet.

So what does the vision say? Continue reading

Health and care: What matters most to older people?

Older people chattingThis week, we have a guest blog from Laura Stuart, Frailty Programme Manager at UCLPartners, a world-leading centre for research, healthcare and education.

Continue reading