1. East Midlands Clinical Senate Dr Ben Pearson

2. East Midlands Clinical Senate “Commissioning services for an ageing population and those living with frailty”

3. Advisory reports: Physical activity and exercise medicine

4. Commissioning services for an ageing population and those living with frailty

5. A mandate for change “The NHS must change to meet the needs of a population that lives longer, for the millions of people with long-term conditions, and for all patients who want person centred care. It means breaking down the boundaries between family doctors and hospitals, between physical and mental health and between health and social care.” - Simon Stevens

6. Complexity … 6 Memory clinic Optician New dentures Cardiologist outpatient appointment Waiting list for hip replacement Multidisciplinary Falls Clinic Social care needs assessment

7. A new paradigm 7

8. The demographic imperative 8 Admitted falls with complications £47,442,307 2013 Admitted falls with complications £78,754,230 2030

9. The demographic imperative 9 Admitted falls with complications £47,442,307 2013 Admitted falls with complications £78,754,230 2030

10. Frailty 10

11. Regional examples 11 Neighbourhood teams Frail Elderly Assessment Team Community teams Integrated health and social care model Care Home quality improvement

12. Commissioning services for an ageing population and those living with frailty 12