Millions of elderly patients are missing out on vital NHS checks that could prevent falls, disability and hospital admissions in what MPs have branded an "unacceptable" postcode lottery.
A damning parliamentary report found family doctors assessed just 17 per cent of patients aged 65 and over for frailty last year – meaning more than four in five older people received no formal assessment at all. The findings raise concerns huge numbers of vulnerable pensioners are slipping through the net as England's population ages.
The report, published today by Parliament's Public Accounts Committee, examined how the NHS identifies and supports people living with frailty – a condition linked to ageing that leaves people at greater risk of falls, disability, hospital admission and the need for long-term care. GPs are contractually required to identify older patients living with moderate or severe frailty and provide extra support to those at greatest risk.
Frailty assessments can trigger interventions such as medication reviews, falls risk assessments, nutrition checks, mobility assessments, care planning, and support aimed at helping older people stay independent and avoid emergency hospital admissions. However, the committee of MPs found the system is failing many of the people it is supposed to protect.
In 2024/25, around 226,000 patients were identified as living with severe frailty – the group considered most vulnerable to serious health problems. Yet despite being diagnosed, most failed to receive the follow-up support required under NHS contracts.
Just 16 per cent received a medication review to check whether drugs could be contributing to falls or ill health, while only 18 per cent underwent a falls risk assessment designed to help prevent potentially life-changing accidents. The committee concluded: "This is not acceptable care."
Experts say failing to identify and support frail older people is likely to cost the NHS more in the long run. Without early intervention, vulnerable patients are more likely to suffer falls, medication problems and worsening health, increasing their chances of ending up in A&E, being admitted to hospital or requiring long-term care.
The committee said preventative care can help older people remain independent for longer while reducing demand on already stretched hospitals and care services. Professor Carl Heneghan, Director of Oxford University's Centre for Evidence-Based Medicine and an urgent care GP, said the findings reflected a growing gap between what the NHS expects and what frontline services can realistically deliver.
Millions of elderly patients are missing out on vital NHS checks
| GETTYHe said: "Dealing with frailty isn't just about seeing a GP for 10 minutes to check how you are. People who are frail and elderly need to see a GP for a comprehensive assessment.
"This needs to be resourced appropriately, and if you don't do that, then it's just a tick box exercise. There aren't enough resources in primary care to provide comprehensive geriatric assessments, which include nutrition analysis, falls assessment, medication reviews and many other things.
"A 10-minute chat with the GP will just not cover this. If you want to institute this, you need to invest more resources in the community and into these assessments.”
MPs said older people were facing an unacceptable postcode lottery depending on where they lived. Across England, 32 of the 106 local NHS areas assessed fewer than 10 per cent of patients aged 65, who are most at risk of serious illness, falls and loss of independence.
LATEST DEVELOPMENTS
Four in five older people received no formal assessment
| GETTYBy contrast, nine NHS areas assessed more than 90 per cent of eligible patients, suggesting far better performance is possible. The report also raised fresh concerns over the future of local NHS services.
MPs warned that planned cuts to Integrated Care Boards – the organisations responsible for planning and commissioning local health services – could make the situation worse. NHS England has ordered ICBs to reduce their running costs by 50 per cent, prompting large-scale redundancy programmes across the country.
The committee said it was "deeply concerned" the cuts had not been properly thought through and warned they could undermine the ability of local health leaders to improve services and tackle poor performance. Committee chairman Sir Geoffrey Clifton-Brown said: "Those at risk of frailty need preventative and follow-up care – indeed, the value of this kind of care is so well-established that it is a requirement in GPs' contracts.
"Yet our report shows that in too many parts of the country, GPs are simply unable to do this important work, overloaded as they have been with new and expanding priorities from NHS England. NHS England has been hyper-focused on ensuring people's access and digital access to general practice.
"However we have an ageing population in this country, with millions of people at risk of frailty. Our report must act as a warning that any success in ensuring such access must not be built by a system turning its face away from older people as it priortises other things.”
The warning comes as England faces a rapidly ageing population. Official projections show the number of people aged 85 and over is expected to rise by around 73 per cent by 2045.
Researchers have estimated frailty already costs the UK healthcare system up to £6billion a year.
GB News has approached the Government for comment.
Our Standards: The GB News Editorial Charter