The Enhanced Frailty Team (EFT) is an NHS community service made up of specialist Frailty Doctors and Frailty Nurses, including Advanced Nurse Practitioners (ANPs). Our team supports patients who are living with frailty and have more complex health needs.
We visit all patients in their own homes. Many people living with frailty have limited mobility or may feel anxious about leaving their homes, so we aim to bring care directly to them. Our main goal is to provide the right support for each individual, recognising that “help” can mean different things to different people. Often, we only fully understand what support is needed once we have met the patient and seen their situation first-hand.
During our visits, we speak with patients, as well as their family members, friends, and carers where appropriate. This helps us ensure that everything possible is being done to support the patient. Our approach is holistic, meaning we consider the whole person rather than focusing on a single medical problem.
For example, when someone sees a cardiologist (a heart specialist), the focus is primarily on the heart – such as scans, investigations, and medications related to heart health. In contrast, our team looks at all aspects of a person’s wellbeing, not just their medical conditions. For people living with frailty, even small changes in health, environment, or support can make a significant difference.
We aim to empower patients and their families by helping them feel informed and confident when making decisions about their care.
Our team can support patients and families in a number of ways, including:
Patients are usually referred to our service by their GP, who outlines their concerns. Before making the referral, the GP should discuss our service with the patient and obtain their consent.
Once we receive a referral, our team will review and triage it, usually within 3–5 working days. If appropriate, we will then arrange a home visit to carry out a Comprehensive Frailty Assessment (CFA), typically within 7–10 working days after triage. At particularly busy times, waiting times may be slightly longer.
During the first visit, we carry out the Comprehensive Frailty Assessment. This is a detailed and wide-ranging discussion that helps us understand all aspects of the patient’s life. It may include conversations about their background, family and social support, personal beliefs, preferences for care, daily routines, and level of independence.
After our team has completed our assessment and provided the necessary support and recommendations, the patient is usually stepped down (discharged) back to the GP’s frailty team for ongoing care. If further input from our service is needed in the future, the patient can be stepped up again for review.
All patients remain under the care of their GP at all times. Our service works alongside GP practices to provide additional specialist support when needed.
Please note that patients must be registered with a Harrow GP to access this service.
If you have any questions about the service, please contact us:
Telephone: 020 3989 5780
Email: harhl.wholesystems@nhs.net
I am a substantive Consultant Rhinologist, Facial Plastic and ENT Surgeon. I am the clinical lead for community ENT for The Royal National ENT (UCLH) and enjoy supporting colleagues in primary care.
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