Why should we assess the degree of frailty in primary care?

Caring for people living with frailty is core business for general practice.When identifying frailty, clinicians often say they 'know it when they see it'. 1 Increasingly, primary care is encouraged to assess frailty more explicitly: to name it, score it, and code it.Many question what value this adds. 1,2Here, we outline why we believe identifying and communicating the degree of frailty is a key aspect in delivering personalised care to older people within primary care. What is frailty?Frailty describes a person's vulnerability to adverse health outcomes.More specifically, it expresses reduced ability to resist potentially damaging stress ('robustness'), such as an infection, a drug side effect, or a fall, coupled with delayed or incomplete recovery following a physiological insult ('resilience'). 3Practically, these events manifest as delirium, falls, reduced mobility, social withdrawal, and loss of independence.Often acting together, these factors increase the need for care. 4These events often feel sudden and unexpected to patients and relatives.However, frailty assessment allows us to judge the likelihood of these acute events and, with the benefit of continuity, understand a patient's trajectory.A proactive approach to frailty, informed by an accurate assessment of frailty severity, allows these events to be anticipated, planned for, or prevented, and for future care needs to be planned for and delivered in ways that align with patients' values and priorities. 5