Recommendation 12

NHSE has set requirements for ICBs and GPs to provide health services that aim to assess and support people living with moderate and severe frailty.25 NHSE considers that ICBs are responsible for managing and measuring performance of many of the services that aim to support people living with frailty.26 NHSE told us that ICBs are responsible for commissioning services to meet the needs of their population but that it is also their responsibility to make sure that commissioned services are happening as contracted. However, there is limited national level data on some frailty related services, and what is available only measures some aspects of performance. This stops NHSE having a good national understanding of the quality of services provided and prevents ICBs benchmarking their performance with others. NHSE also recognised that while providers are responsible for delivering the services “some of this is everybody’s responsibility” and agreed that this introduced the risk that sometimes everybody’s responsibility becomes nobody’s.27 NHSE was aware that this system of accountability is challenging for ICBs given the large numbers of providers in general practice and community services.28