Previously known as Frailty Hubs, this project aims to offer multi-disciplinary care to support people with complex and long-term conditions, enabling them to live happier and healthier lives. The group of professionals offer different skills and meet weekly to work together to focus on every aspect of patients’ care. The aim is to help patients to continue to live independent lives and avoid hospitalisations.
The team also support the Ageing Well initiative which is about working together on transformational projects, sharing best practice and expertise and keeping the patient at the centre so that care for people as they get older is proactive and helps prevent deterioration. It aims to be holistic, has less ‘hand offs’ and enables patients to live at home for as long as possible, and die well.