Community-based health and social care demand associated with frailty in people aged 50 and over in England 2025-40: routine data analyses and simulation modelling.

BACKGROUND

In ageing populations, frailty prevalence and associated demand for health and social care services are expected to increase. Whilst there is good evidence about the demand for primary and secondary care services, the estimated demand for community-based health and social care associated with frailty is not known.

AIM: To estimate future demand for community-based health services and publicly funded social care for those aged ≥50 with frailty, in England.

METHODS

Analysis of cohort data from North-West London provided rates of mental health, community health and publicly funded social care contacts among the population aged 50 and over, by age and electronic frailty index (eFI) categories. Using System Dynamics (SD) simulation modelling, mean service use and population estimates informed projections of national demand over 16 years (2025-40).

RESULTS

Over the simulation period, mental health, community health and publicly funded social care use are projected to increase by 16%, 30% and 30% respectively. Against baseline, lowering frailty incidence could reduce mental health, community health and local authority social care contacts by 1.4, 10 and 400 000 m respectively, between 2025 and 2040. Slowing frailty progression could reduce mental health, community health and social care contacts, compared with baseline, by 2.8, 45.3 and 2 m respectively over the same period.

CONCLUSIONS

Demand for community-based health and social care services will increase substantially as the population ages and becomes more frail. Reduced frailty incidence and progression could slow demand growth, but demand will continue to grow due to large numbers already living with mild to moderate frailty.