IFIC Canada Virtual Community Care January 2024

IFIC Canada Virtual Community Care January 2024


12:00 pm - 1:30 pm

Event Type

IFIC Canada Virtual Community Care January 2024

Meeting the Needs of People Living with Frailty:
Lessons from the Jean Bishop Integrated Care Centre UK

The NHS is under increasing strain. With an ageing population, hospitals struggling with soaring demand and the biggest ever workforce crisis, the NHS is in need of long term solutions. Innovation and new ways of working are required that might offer the NHS the lifeline it needs.

Now in its fifth year, the Jean Bishop Integrated Care Centre in Hull is a leading example of NHS, social care, voluntary sector, and fire and rescue services working collaboratively to keep thousands of frail and elderly people in the surrounding area fit, out of hospital and living independently at home or in their care setting.

The multi-disciplinary team provides proactive (anticipatory) Comprehensive Geriatric Assessment and also an urgent (reactive) response for those in crisis.


1. Appreciate and see evidence of how upstream care in the community can prevent the need for institutional care.
2. Understand mechanisms whereby seniors and others in pending medical need can be proactively identified in the community.
3. Gain knowledge in how cross-sector teams are formed and work to meet needs from a patient and family perspective
4. Appreciate how proactive, community-based care can address components of the quadruple aim

Patient Reported Outcomes include:

  • Sustained improvement in emotional and physical wellbeing post assessment
  • Surveys have given a vivid insight into the impact the ICC is having on the lives with patients reporting they:
    • felt supported by the range of healthcare professionals
    • had adequate time and opportunity to discuss any worries or fears and health problems
    • felt informed and empowered during their consultation and in planning their future care

Join this session to hear more from the team that helped design and implement this sustainable model of care that is making a real difference to the lives of people affected by frailty and their families.


Dan & Anna
Consultant Community Geriatricians
Strategic Clinical Leads for Frailty
Hull and the East Riding of Yorkshire, England



Dan & Anna are Consultant Community Geriatricians and Strategic Clinical Leads for Frailty in Hull and the East Riding of Yorkshire, England. They have worked collaboratively with commissioners, health and social care providers to deliver an award-winning community frailty model based at the Jean Bishop Integrated Care Centre, Hull. Since 2018, the specialist multi-disciplinary team have delivered proactive comprehensive geriatric assessment for people living with frailty resulting in a sustained improvement in patient and system outcomes. They have also implemented a 7day Urgent Community Response (UCR) model and Frailty Virtual Ward which provide safe and effective community-based frailty care.

They have been involved in several research initiatives focused on improving older people’s care and have partnered with NHS England, NHS Elect and the British Geriatrics Society to inform policy and practice in England.

Sharon Anderson
Research Coordinator
Caregiver-Centered Care Program of Applied Research & Innovation, University of Alberta


Sharon Anderson became a double-duty caregiver, a healthcare provider and a family caregiver in 1997 when her husband had a stroke. Surprised by the silos in health and social care and determined to do something about it, Sharon returned to university and completed Master of Education in Community Rehabilitation and Disability Studies, Master of Science in Public Health/ Health Promotion, and PhD in Family Gerontology. She is the Research Coordinator for the Caregiver-Centered Care Program of Applied Research & Innovation in Health Services Delivery in Family Caregiving led by Dr. Jasneet Parmar, Professor, Department of Family Medicine, University of Alberta.