Assessing stakeholder's perception and utilisation of frailty assessment in a vascular surgery setting - a national...

Frailty is common among patients undergoing vascular surgery and is associated with poorer postoperative outcomes. However, the use of frailty assessment tools in vascular services varies considerably. This study explored how vascular healthcare professionals (HCPs) understand frailty and perceive the role of frailty assessment to inform future service development.

A national mixed-methods study was conducted. A questionnaire captured clinicians' knowledge, attitudes, and current frailty assessment practices. Semi-structured interviews with consultant and trainee vascular surgeons and other allied healthcare professionals explored experiences in depth. Quantitative data were analysed descriptively; qualitative data were examined using reflexive thematic analysis. Findings were integrated during interpretation.

Survey responses (n = 60) showed that frailty is widely recognised as clinically important, yet its assessment is inconsistent, with most respondents (73%) relying on subjective judgement rather than formal tools. Interviews (n = 20) identified four overarching themes: (i) conceptualising frailty through a vascular lens; identifying (ii) drivers for change in approach to frailty; the (iii) assessment of frailty by the vascular team was varied but important; and HCPs identified potential risks and benefits to (iv) operationalising frailty for vascular services. Clinicians perceived value in standardising frailty assessment to support early identification, guide optimisation, enhance shared decision-making, and create a common language across specialties. Participants described benefits of collaborative models involving geriatricians, including improved medical management, streamlined discharge planning, and better continuity across hospital-community interfaces. However, barriers included limited time, staffing constraints, uncertainty about tool selection, concerns about service ownership and potential deskilling. Most clinicians felt a multidisciplinary frailty-informed model would ultimately improve outcomes and patient experience if adequately resourced.

Vascular HCPs consider frailty assessment clinically meaningful and potentially transformative, but current practice is inconsistent. Participants perceived strong value in standardising frailty assessment to improve education, awareness and a shared understanding which would promote cross-disciplinary working. Improved health outcomes, patient counselling/education and job role satisfaction were implicated in this movement. However, optimal tool selection and its impact on clinical outcomes remain uncertain and require prospective evaluation before widespread adoption.