Frailty and multimorbidity are terms used to describe people at risk of worsening health, increasing disability and death. These are often older people who have multiple health problems and frequently present to health and social care services at a point of crisis. However, identifying these vulnerable people earlier may allow extra support and assessment to prevent such crises. There are multiple ways of identifying multi-morbid people, but our current record systems for primary care (GP practices), secondary care (hospitals) and social care are not well connected.
In this project, we will bring data together data from GP and hospital records to provide a combined view of patients’ health and care information to health and social care partnerships in the Lothian region. These groups are responsible for services that impact the health and wellbeing of the population. No individual level patient data will be shared as part of this project.
