The report from the Public Accounts Committee (PAC) finds GPs are not meeting contracted requirements to identify, assess and support people living with frailty.

Sir Geoffrey Clifton-Brown, chair of the PAC, said: ‘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 prioritises other things.'

Just 17% of patients aged 65 or over were assessed for frailty in 2024-25. Of the 226k people diagnosed with severe frailty in the same year, only 16% had a medication review and 18% had a falls risk assessment.

NHSE told the PAC it is looking at other healthcare professionals sharing the service, such as community pharmacists undertaking medication reviews – but the inquiry received evidence from pharmacists keen to do this work that it was not adequately funded.

The report highlights significant and unexplained regional variation in support for people with frailty. In 2024-25, 32 of 106 local NHS areas assessed less than 10% of their registered patients aged 65 or over. By contrast, nine NHS areas assessed 90% or more of this group.

The MPs warn it is not clear exactly who is responsible for improving performance between local health boards who commission services, and those, including GPs, who deliver them.

The report, which comes in the context of NHSE's planned 50% cuts to local health boards, announced in April 2025, calls on NHSE and DHSC to set out how:

• by the end of 2026, they will ensure GPs assess more people with frailty and provide the severely frail with adequate support
• they will reduce variation in support for people with frailty by establishing a threshold for intervening in areas of poor performance
• new accountability arrangements will improve how GPs assess and support people living with, or at risk of, frailty
• the basis on which NHSE considers GPs and general practice have the capacity to deliver the full ranges of services and responsibilities expected from them
• NHSE to write to the Committee with details on what it has done to assess of the expected impact of new and expanding priorities on continuity of care for patients with frailty and for digitally excluded patients with frailty
• how neighbourhood health teams will share responsibilities and balance the load of assessing and supporting people with frailty
• what further reassurances they can provide to the Committee that ICBs' cost reductions will not impact on ICBs' ability and capacity to carry out their functions effectively.

An NHS spokesperson said: ‘Patients rightly expect quick, easy access to their local GP team and we know for lots of people this is moving in the right direction thanks to the hard work of practices up and down the country to implement measures to improve phone lines and online options – with more than seven in 10 people saying it was easy to contact their practice.

‘While this focus to improve access is starting to pay off, we clearly need to ensure older patients and those living with frailty continue to get the care and support they need and new neighbourhood health teams, working alongside GPs and community services should help shift the focus to priority groups of patients, including those with frailty and dementia.'