Background People with frailty approaching end of life rarely access hospice services (Hospice UK. Equality in hospice and end of life care: challenges and change. 2021; Tobin, Rogers, Winterburn, et al. BMJ Support Palliat. Care. 2020;12:142–151), yet symptoms and concerns impact daily activities and quality of life. Prognostic uncertainty limits opportunity for advance care planning conversations (Combes, Nicholson, Gillett, et al. Palliat Med. 2019;33(7):743–756). Hospice UK funding enabled the development and evaluation of a Frailty Wellbeing Programme (FWP) to support moderately frail people to self-manage symptoms and start thinking about future care.

Aims To evaluate the accessibility and effectiveness of a new programme for moderately frail people, incorporating palliative rehabilitation.

Methods A multi-disciplinary group designed a six-week Frailty Wellbeing Programme to address unmet needs alongside an evaluation plan with PPI input. Referral sources include GPs, frailty leads and social prescribers. To increase reach, online self-referral is advertised and encouraged. To access the Frailty Wellbeing Programme, patients first attend a physiotherapist assessment. Process measures, the Integrated Palliative Care Outcome Scale (IPOS) and 12-item World Health Organization Disability Schedule 2.0 (WHODAS) are completed at assessment and on completion of the Frailty Wellbeing Programme.

Results The project is ongoing. Since October 2023, n39 referrals have been received (n19 self-referrals). Of the n39 referred, n5 have not accessed the programme due to: awaiting assessment (n=2), living outside catchment (n=2), or ineligibility (n=1). 34 patients were assessed. Of those, n9 completed the Frailty Wellbeing Programme, n13 are waiting or mid-programme, n12 did not attend due to: preferring other outpatient groups (n=3); deteriorating health (n=3); moving away (n=1); declining support (n=2); death (n=3).

Following completion of the Frailty Wellbeing Programme, n8 (89%) returned for exercise interventions; n1 (11%) attended a baking group. Three patients booked advance care planning conversations. IPOS and WHODAS data will be analysed at project completion.

Attendees provided feedback: ‘We both felt lighter.’; ‘All sessions were very helpful, especially the exercises.’

Conclusion The Frailty Wellbeing Programme enables moderately frail people to access hospice outpatient services. Initial outcomes suggest a positive impact. Organisational awareness of frailty support has grown.