HISES Innovation PhD Fellowship – Frailty

Theme Title: Evaluating innovative approaches to proactive care for older people living with frailty


Our ageing population has placed unprecedented demand on health and social care services. In partnership with NHS Lothian and Health Innovation South East Scotland (HISES), the Data Driven Innovation DataLoch programme has been integrating primary and secondary health records with social care data to better understand older people in our region at highest risk of decline. A registry of over 5,000 older people currently living with frailty has been created, with live dashboards providing enhanced views of this population for clinicians to support proactive, rather than reactive, care. Using existing support from SHIP, we are developing this register further, to include additional automated frailty tools from routine data, process measures of optimum geriatric care, and outcomes data such as hospitalisations to track progress of interventions. A PhD candidate would join the ‘Frailty Innovation Living Lab’ ecosystem being created through this work, which will develop a consent model to allow older people living with frailty to test new health and care technologies within their own home. The ultimate purpose of this work is to identify health deteriorations earlier, and to predict the potential need for unplanned health or care interventions.

Host Test Bed: HISES; Data Driven Innovation Programme, University of Edinburgh

Proposed HEI: University of Edinburgh

Test Bed Lead contact: Prof Tim Walsh:  timothy.walsh@ed.ac.uk

Innovation Lead contact:   Dr Atul Anand, University of Edinburgh   atul.anand@ed.ac.uk

Demand signalling priority area: managing long term conditions / frailty


Problem statement

As our population ages, the demands on health and care services are increasing. People living with frailty are particularly susceptible to increased care needs and emergency hospitalisation. While most older people are not frail, data from one area of Edinburgh suggests that fewer than 3% of the moderately or severely frail older population account for over one third of all occupied hospital bed days. Well established comprehensive geriatric care already offers evidence-based interventions to prevent some of these expected harms. However, as frailty lacks the diagnostic criteria of a single health condition, routine health and care data has struggled to identify and track this population in real-time, or to proactively deliver appropriate interventions prior to a health or care crisis.

Proposed area of work

A successful PhD candidate would be embedded within the Frailty Innovation Living Lab, benefitting from the collaborative environment between HISES, the University of Edinburgh (Usher Innovation and DataLoch programmes) and clinicians (GPs and secondary care geriatric medicine physicians). The PhD candidate would evaluate person-reported experience measures for these new technologies, develop risk prediction and visualisation tools using routine data, and support the independent academic appraisal of test interventions led by technology companies working in partnership with HISES.


The need to move healthcare upstream of hospitalisation for older people living with frailty is well recognised, but a lack of robust identification and implementation framework has prevented significant change across the target population. Given the high unplanned hospitalisation risk associated with frailty, even small improvements could deliver significant benefits for local health and care services, as well as improving the lives of older people. Integrated routinely collected data now offers this innovation platform, with strong support from clinicians, NHS boards and local authorities. A PhD candidate would be expected to support the deployment of new technology for older people living with frailty to maximise independence in their own homes for longer.

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Contact: innovationfellowship@gov.scot