Here in Perth and Kinross, we are working to improve how people are supported to live well as they age.
Our Health and Social Care Partnership (HSCP) is aligning with Healthcare Improvement Scotland's Ageing and Frailty Standards (November 2024) to strengthen support for older people across our communities.
These standards provide a clear, evidence‑informed framework for delivering proactive, person‑centred care that helps people maintain independence, wellbeing and quality of life.
They emphasise:
- early identification of frailty
- coordinated, multidisciplinary support
- support for unpaid carers and families
- maintaining mobility, nutrition and independence
- safe and effective use of medication
- addressing mental health and wellbeing
- timely, joined‑up care when needs change
On this page you'll find information about:
- what the Ageing and Frailty Standards are and why they matter
- how Perth and Kinross HSCP is implementing these standards
- how teams are working together across services
- how we are supporting high‑quality, compassionate care
- updates and developments in relation to this work
As Scotland's population ages, more people are living with frailty. The Ageing and Frailty Standards set out a clear ambition: care should be built around the person, not the system.
They focus on what matters most to each individual - their goals, their strengths, and the life they want to live.
This means working in partnership with people and families to support independence, connection and wellbeing, while recognising change and supporting good decision‑making at every stage.
When applied well, these standards help ensure people feel supported, families feel included, and staff can provide consistent, compassionate care.
They play an important role in helping ensure that every older person in Scotland is supported to live well, with dignity, choice and respect.
What are the Ageing and Frailty Standards?
Healthcare Improvement Scotland's Ageing and Frailty Standards set out 11 evidence‑based expectations for how services should support older people living with frailty across all care settings.
The standards focus on early identification of frailty and ensuring that people receive coordinated, multidisciplinary support that responds to their needs. They emphasise the importance of valuing and supporting unpaid carers, promoting activity and mobility, and supporting good nutrition and hydration. They also highlight the need to address bladder and bowel health, ensure the safe and person‑centred use of medicines, and support mental health and wellbeing.
In addition, the standards focus on responding quickly when a person's condition changes and ensuring that people receive safe, high‑quality care when they are in hospital.
Together, these standards provide a consistent national framework to support positive ageing. They place a strong emphasis on person‑centred care, ensuring that support is shaped around what matters most to each individual, including their goals, preferences and rights.
You can explore the full standards and supporting resources through Healthcare Improvement Scotland.
Why do the Ageing and Frailty Standards matter?
The Ageing and Frailty Standards matter because they place people's choices, autonomy and lived experience at the heart of care. By focusing on early identification, coordinated support and what matters most to each individual, the standards help ensure that older people living with frailty have greater control over their health, daily life and future planning.
This person‑centred approach improves not only the individual's experience of care, but also provides clarity, reassurance and support for families, loved ones and unpaid carers, recognising the vital role they play.
The standards also provide a shared, national framework that supports the workforce to deliver consistent, compassionate and well‑coordinated care across all settings. This helps create a more confident and connected care environment, where people feel understood, respected and involved in decisions about their wellbeing.
They set out how health and social care services in Scotland should work together to support older people and those living with frailty, encouraging a joined‑up approach across health, social care and communities.
The standards focus on understanding what matters to each person, supporting independence, and recognising that frailty can change over time. They promote early identification, shared decision‑making, and care that adapts as needs change.
Importantly, they encourage realistic and meaningful care that respects people's wishes, values their strengths, and supports them to live well for as long as possible.
What difference can the Ageing and Frailty Standards make across Perth and Kinross?
The Ageing and Frailty Standards can make a significant difference across Perth and Kinross Health and Social Care Partnership by providing a shared and consistent framework that aligns services around early identification, coordinated support and person‑centred care.
By setting clear expectations for prevention, early intervention and integrated multidisciplinary working, the standards support teams to work together more effectively. This helps reduce variation in practice and improves outcomes for older people living with frailty.
They also strengthen collaboration with unpaid carers, recognising and supporting the important role they play, while providing staff with clearer guidance to support confident decision‑making and consistent practice.
Overall, the standards support the delivery of more coordinated, rights‑based and compassionate care. This helps ensure that older people and those who support them experience smoother care pathways, better communication and more timely, responsive support across all services.
Methodology and learning culture
Here in Perth and Kinross, we are committed to developing a positive learning culture where individuals, teams and services are supported to learn, improve and flourish together.
We use the Scottish Approach to Change on the Healthcare Improvement Scotland website to support how we improve care with and for people. This approach brings together a range of practical methods and tools that help us plan, test and deliver meaningful improvements in a structured and accessible way.
A strong learning culture sits at the heart of this approach. It recognises that sustainable improvement happens when teams are supported to reflect, learn and adapt together. By using evidence‑based methods, staff are able to translate ideas into practice, build confidence in improvement work, and respond effectively to the changing needs of people and communities.
This includes using approaches such as testing and learning, evaluating what works, and sharing good practice across teams and services. These methods help to strengthen decision‑making, improve consistency, and support more joined‑up ways of working.
By embedding this approach across Perth and Kinross, we are creating the conditions for safe, effective and person‑centred care that continues to evolve and improve over time.
There are also a range of national and local publications that support Ageing and Frailty. In Perth and Kinross, we use these strategic documents to help guide priorities, evidence quality, identify opportunities for improvement, and connect with wider national work in this area.
