Adapting the WHO Best Buys Principles to Frailty Care in Canada

Using the example of frailty care in Canada, this discussion paper was completed in 2021 and presents an adaptation of the WHO Best Buys principles as a tool to support higher-level decision making and priority setting for high-value healthcare investment. Our goal is to support decision-makers to reduce the preventable and avoidable burden of morbidity, mortality and disability due to frailty through Best Buys investments. Based upon the material we present in this document, we recommend a phased process of deliberation to identify high-value actions to improve care. This process involves developing a list of possible policy actions and interventions, then reviewing these to assess:  Value, including clinical benefit, impact on the health system, and impact on budgets, Feasibility, and Capacity, including both financial and non-financial criteria. There are some potential investments which require significant changes to existing practices, or new physical or human resources. What is desirable may not be immediately feasible. In addition to criteria for examining investments in specific activities, we note there are Foundational Investments required to improve the overall care system. This would include activities such as standardization of the measurement of frailty across services, education and training programs, and development of an inventory of tools. The initiative was supported by funding provided by Healthcare Excellence Canada.

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