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Frailty Team pilot reduces hospital attendances by half

Rachel Matheson at CACT event Oct 2025

The incredible achievements of our Frailty Team were showcased during an event for primary care colleagues in Greenwich.

More than 350 people came together to mark the launch of a new neighbourhood health and care approach in Greenwich borough – a bold step towards more joined-up, community-based support for local residents.

During the event, Rachel Matheson, Associate Director for Oxleas’ Adult Community Services in the borough, revealed that a pilot by our Frailty Team has reduced patient emergency attendances by a staggering 53%. They’ve done this by bringing a range of partners and services together to support people to keep well at home.

The audience heard how the Greenwich frailty service brings experts together in a multi-disciplinary approach to supporting people. The service, which launched in 2020 as a pilot and was later rolled out to the whole borough, is helping to support people proactively in their own homes, reducing pressure on hospitals and the London Ambulance Service. It is core to the future neighbourhood approach as part of the 10 Year Health Plan for England.

In Greenwich, the neighbourhood health and care approach will initially focus on long term conditions, frailty and children’s services and aims to expand to other health and care priorities next year, including urgent same day care.

Dr Ify Okocha, Oxleas Chief Executive, said: We have many more challenges than we did 30 years ago, and we need to work together as partners to respond. 

As the integrator in Greenwich, Oxleas will be working with partners to help us achieve the solutions needed. 

All partners have a role to play and by working together we can do things better and have better outcomes for local people.

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