Table 1.
Template for the first round of the Delphi Survey
| Item | Inclusion? | Comment |
|---|---|---|
| Frailty core capabilities framework | ||
| 1. Understand frailty | ||
| 1.1 Definition and prevalence | ||
| 1.1.1. Knowing that as a construct, frailty is an age-associated condition of reduced resilience and increased vulnerability to adverse events | Please choose an element | |
| 1.1.2. Knowing that frailty becomes more frequent with ageing and can be defined through the frailty phenotype and the “cumulative deficit” models of frailty | Please choose an element | |
| 1.2 Disability, multimorbidity and dependency | ||
| 1.2.1. Understand the concept of frailty as a multidimensional condition and recognize its individual nature and stages including all determinants of health identified by the WHO | Please choose an element | |
| 1.2.2. Understand that as a construct, frailty is potentially reversible with recognized transitional stages from robust, and pre-frail through to end of life | Please choose an element | |
| 1.2.3. Knowing that the trajectories of frailty are influenced by lifestyle and other factors including the risk of frailty syndromes such as confusion, falls, incontinence, problems with mobility and side effects of medication | Please choose an element | |
| 1.3 Personal impact | ||
| 1.3.1. Understanding the multidimensional, heterogeneous nature of frailty and its bidirectional relationship with many different aspects of a person’s life (including multimorbidity, functional ability, physical health, psychosocial health and cognitive function) | Please choose an element | |
| 2. Identification of frailty | ||
| 2.1. Screening, diagnosing and assessment | ||
| 2.1.1. Apply common tools suggested in the Frailty Prevention Approach (FPA) document to support the identification and the process of assessment (CGA) of frailty severity including as part of an integrated care approach | Please choose an element | |
| 2.1.2. Knowing that frailty assessment should include consideration of the potential use of assistive technology (AT) | Please choose an element | |
| 2.1.3. Understand that frailty syndromes may be a first presentation or first sign of frailty | Please choose an element | |
| 2.1.4. Understand the importance of early recognition and timely management of frailty syndromes | Please choose an element | |
| 3. Person-centred collaborative working | ||
| 3.1. Person-centred approaches including communication | ||
| 3.1.1. Understand that person-centred care includes all elements of a person’s life that are important to them | Please choose an element | |
| 3.1.2. Understand the implications of relevant legislation and guidance for consent and shared decision-making (e.g. mental capacity legislation) | Please choose an element | |
| 3.1.3. Person-centred care requires being able to communicate verbally and on a non-verbal basis with older people to achieve shared decision-making in the FPA | Please choose an element | |
| 3.1.4. Demonstrate effective communication with family and carers to support them in their individual care-giving role | Please choose an element | |
| 3.2. Collaborative and integrated working | ||
| 3.2.1. Be able to work in partnership with others, exploring and integrating the views across multidisciplinary teams and organizations to deliver care in a coordinated and integrated way, showing an understanding of the role of others | Please choose an element | |
| 3.2.2. Be able to share information with other professionals, including an older person’s wishes, in a timely and appropriate manner, considering issues of consent and confidentiality | Please choose an element | |
| 4. Managing frailty and its prevention | ||
| 4.1. Preventing and reducing the risk of frailty progression | ||
| 4.1.1. Know interventions to improve independence and quality of life for people at risk or living with frailty, including social and economic factors, exercise, physical activity, diet, hydration and proper drug management for preventing and reducing the progression of frailty. | Please choose an element | |
| 4.1.2. Be able to measure, monitor and report important measures of frailty outcomes in different settings including all determinants of health | Please choose an element | |
| 4.2. Living well | ||
| 4.2.1. Understand the concept and principles of a community development, asset-based approach to care and support for older people at risk of frailty or those already living with frailty | Please choose an element | |
| 4.3. Promoting independence | ||
| 4.3.1. Be able to provide specific advice and guidance on changing or adapting the physical and social environment to ensure physical safety, comfort and emotional security | Please choose an element | |
| 4.4. Community skills | ||
| 4.4.1. Be able to promote the benefits of developing community skills and engaging with the local community, amongst colleagues and senior managers/board members in relation to improving outcomes for people living with frailty and those important to them | Please choose an element | |
| 4.5. Care and support planning | ||
| 4.5.1. Understand the importance of care and support planning being a “holistic” and person-centred process at all levels of care that needs to be reviewed regularly | Please choose an element | |
| 4.6. Research and evidence-based practice | ||
| 4.6.1. Understand the reasons for conducting service evaluation and research and be able to participate in service evaluation and research in the workplace | Please choose an element | |
| 4.6.2. Understand how local and national policy and the outcomes of research in frailty care and support can inform and impact on workplace practices and care delivery | Please choose an element | |
| 4.7. Leadership in transforming services | ||
| 4.7.1. Understand the importance of continuing professional development to ensure the methods used for preventing frailty are robust, valid and reliable | Please choose an element | |
| 4.7.2. Understand that everyone has a part to play in supporting people living with frailty to have the best possible quality of life | Please choose an element | |
| 4.7.3. Be able to provide support for colleagues to develop their skills and confidence when working with older people at possible risk of frailty and those important to them | Please choose an element | |
| 4.7.4. Be able to use people’s feedback and person-centred outcomes to coproduce investments in services with those who use them | Please choose an element | |
| 4.7.5. Recognize the importance of effective clinical governance which involves all stakeholders for overall management of frailty | Please choose an element | |
This template included four domains based upon professional competences from projects and best practice models and represents a comprehensive overview of current content in literature for professional competences in frailty prevention and management