The development of a 7 Day Frailty SDEC at Queen Elizabeth the Queen Mother Hospital, Margate

Introduction 

The development of specialist acute frailty services is well recognised as crucial to meet the needs of our ageing population and is recommended by the NHS England Long Term plan. At the same time, same day emergency care (SDEC) services are rapidly expanding as an alternative to ED However, to date there is a limited evidence base for specialist frailty SDEC units. 

Methods 

We ran a 6-week pilot of a 7-day specialist frailty SDEC open from 8am-6pm. The unit was staffed by consultant geriatricians, frailty ACPs, specialist nurses, junior doctors, a therapy team and resident pharmacists. Patients were accepted both directly from the community (GPs, ambulance crews community frailty teams) and from ED. Criteria were loosely defined by Clinical Frailty Score (CFS 5 or above) and NEWS <3. 

Results 

A total of 256 patients were reviewed in the frailty SDEC over the 6 week pilot period. 166/256 (65%) of patients stayed <24 hours and a further 48 (19%) had a short stay of between 24-72 hours. 7-day ED re-attendance rates remained low at 6% (16/256) and 10% (26/256) of patients were re-admitted to hospital within 30 days of discharge (compared to 17.9% England national average for 2023-2024). 

Conclusions 

Frailty SDEC provides a safe, effective environment for rapid comprehensive geriatric assessment of patients living with frailty. Through close links with community teams we facilitate admission avoidance and person centred care in the right place, first time.