Extending Frailty Care

Frailty is a leading cause of death in older people, and those with frailty are likely to form the largest proportion of people with palliative care need. Yet people with frailty are often underserved at end of life.

Hospices are uniquely placed to support a system change enabling better quality of life for older people with advancing frailty; we have a history of responding to the voice of individuals, working creatively to deliver and support care across the care continuum.

This programme invites hospices to think differently and creatively to support high quality care for older people with frailty at end of life.

The programme will fund c10 innovative and emerging/developing frailty service delivery models led by hospices across the UK – models that demonstrate and share effective ways of caring for, and working with, older people with frailty.

For full details of the programme, please read the Grant Information and Criteria document in the Apply Now section below.

For the purpose of this grant programme, we have defined frailty as a distinctive health state related to the ageing process, in which multiple body systems gradually lose their in-built reserves (Clegg at al, 2013). People living with frailty often have additional multiple health problems including cognitive decline.



End of life care for older adults living with frailty is different from dying with one disease. The trajectory towards death is more uncertain with episodes of acute illness and periods of full or partial recovery. This programme will focus on care for people who are aged 65 years and over and projects will be expected to focus on advancing frailty as the major end of life need.

Grants of up to £50,000 will be available to support projects over 18 months. This allows for up to 3 months of set-up phase and 12 months of project delivery – with a further 3 months to cover any unforeseen delays mid-project.

The total available funding in this grant round is £500,000.

We expect to award between ten and fifteen grants in this round.

The deadline for applications is 17:00 on 5 December 2022.

Applicants will be informed whether or not they have been successful at the end of January 2023.

Eligible organisations must be adult independent member hospices of Hospice UK and based in the UK.

Only one application can be considered from each hospice

Living and dying well with frailty and palliative care needs; since the passing of the Health and Social Care Act 2022 everyone, irrespective of condition or geography is entitled to palliative care in England. 



People with frailty can experience difficulty receiving palliative care on their individual and personal journeys. It is a priority to support them with the benefits of palliative care in navigating uncertainty, problem-solving and planning where appropriate.



Additionally, we know there's a group of people that do not care to focus on the future or perceive palliative care as something that they could benefit from as they get older, so we are also keen to support people with frailty to live well “in the day.”



We welcome projects from all settings where hospices are working in partnership with other providers for example, hospital; community; care home, voluntary sector and social networks including family.



Examples of potential projects to improve care for people with frailty and palliative care needs could include but are not limited to, the funding of a post, service model or education programme.  Additionally, we encourage applications that broaden access to hospice services to improve equality and diversity in hospice care.

Potential projects will test innovative models of care and ways of working to improve the lives of older people with frailty.



These could include, but are not exclusively limited to, aspects of the following:

• Identification and management of frailty for patients who have palliative care needs and/or are approaching end of life regardless of whether the level of complexity is low or high, or whether the person has cognitive and physical frailty.
• New models of working, such as establishment of virtual wards or information sharing strategies so that patient data flows between hospice; hospital; community; care homes, voluntary sector and social networks including family members.
• Education - upskilling of staff to support caring for people with frailty such as training hospice and domiciliary/residential care staff around difficult conversations and the management of slow decline in the context of frailty.
• Working in partnership across health care settings, to support people, both before and after a crisis, to avoid unwarranted hospital admission or other place changes due to an underlying, unaddressed palliative care concern.
• Improving the patient and service users journey to make navigating the health and social care system easier, by reducing the number of ‘touch points’ or creating contact models such as single point of access.
• Enhance Palliative rehabilitation and strengths-based approaches.
• Mitigating risk by working in partnership with patient and service users, for example by considering in advance interventions such as de-prescribing and/or environmental factors such as those related to falls.
• Support for people with advancing frailty who are reluctant to engage with palliative care.
• Working in partnership with volunteers in a Compassionate Communities approach to developing frailty awareness which will support people with advancing frailty in their personal environments and communities e.g. social clubs, combatting loneliness and isolation, navigating complex family dynamics related to palliation, improving relationships with old age services such as utilities/DIY services to support practical autonomy and independence at home.
• Working in partnership with domiciliary and residential services providing end of life care. This might include the provision of responsive and practical expertise such as a 24-hour response service when patients are approaching a phase of clinical transition or unpredicted or rapid deterioration that requires medical intervention.

It is expected that projects will combine several of these aims in one project.

Of particular interest will be well thought through project plans considering sustainability once funding has ended.

We have commissioned Whole Systems Partnership (WSP) as an evaluation partner for this programme.

All successful applicants will be required to engage with WSP throughout the life of the grant.

An outline timetable for the programme:

• 5 December 2022 - Deadline for submission of applications 17:00.
• Early January 2023 - Major Grants Committee meet to allocate funding.
• End of January - all applicants are to be notified of the decisions.
• End of April - First progress report due from grantees.
• End of April - Project Lead Day (TBC)

Below are a number of resources that you may find helpful.

The list is not exhaustive and will be added to as the Extending Frailty Programme develops.



- Research, policy documents and practical examples.

- Systematic reviews on aspects of frailty.

- Frailty amongst older people in a palliative care context – reading list.

If you have any problems with the online form, or if you have any other queries about this grant programme, please contact the Grants Team at Hospice UK.