New report highlights pressures on GPs and the need for inclusive health and care support
A new report from the Public Accounts Committee (PAC) has raised concerns that growing pressures on general practice are affecting the ability of GPs to provide essential support for older people living with, or at risk of, frailty.
At CSPA, we believe that everyone should be able to access the care and support they need, regardless of their age, circumstances, or ability to use digital technology.
This report highlights an important challenge facing older people today: as health services increasingly focus on improving access through digital routes, there is a real risk that people who are not online, lack confidence using technology, or need additional support could be left behind.
Digital access can bring many benefits, but it must not become the only route to essential services. Older people living with frailty often need timely, preventative support to maintain their independence, and this support must remain accessible to everyone.
The findings also underline the wider pressures facing health and care services. When preventative care and community support are not available, more people reach crisis point and require NHS intervention. A properly funded national social care service has a vital role to play in reducing pressure on the NHS by providing the right support earlier, helping people remain independent for longer, and ensuring care is built around people’s needs.
Frailty support under pressure
The PAC report highlights that while GPs are contractually responsible for identifying, assessing and supporting people living with frailty, many practices are struggling to deliver these requirements alongside growing demands and competing priorities across primary care.
Under the GP contract, practices are expected to identify all registered patients aged 65 and over who are living with moderate or severe frailty and provide appropriate follow-up support.
However, the report found that in 2024/25 only 17% of patients aged 65 and over had received a frailty assessment.
The figures for those identified as having severe frailty are also concerning. Of the 226,000 people diagnosed with severe frailty during the year, only 16% received a medication review and 18% received a falls risk assessment — despite these being important elements of preventative care.
The PAC describes this gap as unacceptable and highlights the need for greater clarity around how services can be delivered effectively within the current pressures facing general practice.
Growing demands on general practice
The report recognises that NHS England has placed significant focus on improving access to GP services, including digital access.
While improving access is important, the inquiry found that prioritising one area of care can create unintended consequences elsewhere.
For older people living with frailty, gaps in preventative support can increase the risk of avoidable health problems, falls, hospital admissions and loss of independence.
The report also considers whether other healthcare professionals could take on a greater role, such as community pharmacists supporting medication reviews. However, evidence submitted to the inquiry highlighted concerns that additional responsibilities are not always matched by appropriate funding and capacity.
Variation across the country
The PAC report also identifies significant differences in frailty care between local areas.
In 2024/25, 32 out of 106 local NHS areas assessed fewer than 10% of their registered patients aged 65 and over. However, other areas achieved much higher levels of assessment, with nine areas reaching 90% or above.
This variation suggests that better outcomes may be possible with existing resources, but clearer accountability, investment and support are needed to help services improve.
CSPA’s view: digital inclusion must remain at the heart of healthcare
The findings of this report highlight a wider issue: health and care services must work for everyone, not just those who can easily access digital systems.
For many older people, technology can be a valuable tool that helps them stay connected and access support. However, for others — including people without internet access, digital skills, confidence, or access to suitable devices — the move towards digital-first services can create new barriers.
No one should be disadvantaged because they are unable to use online systems.
Digital services should improve access, not restrict it. This means maintaining meaningful alternatives, including face-to-face and telephone support, so people can access healthcare and essential services in a way that works for them.
The pressures highlighted in this report also demonstrate the close relationship between health and social care. When community-based support is unavailable or difficult to access, more people rely on NHS services that are already under significant pressure.
CSPA believes a national social care service is needed to provide consistent, reliable support across the country. A stronger social care system would help people remain independent, support unpaid carers, prevent avoidable health crises and reduce pressure on the NHS.
Building a fairer future for health and care
This report is a reminder that improving access to healthcare cannot simply mean making services more digital. It must mean making services more inclusive.
As the population ages and more people face the challenges of frailty, we need a health and care system that recognises the importance of prevention, early support and person-centred care.
CSPA will continue to campaign for a fairer approach where older people and those experiencing digital exclusion are not disadvantaged, and where everyone has equal access to the support they need.
A sustainable health and care system must put people first — ensuring that ageing, frailty or digital exclusion never become barriers to receiving the care and support everyone deserves.
