Abstract
Frailty is prevalent within the local community of the hospital, with long waiting times in ED, the trust has established an FDF service, with a dedicated team based in ED to assess frailty patients, who would have been pended for admission, to ensure they are diverted to appropriate services and discharged to their normal place of residence, as per GRIFT, BGS guidelines and NHS England long term plan.
Method
Data was audited over a 7-month period, all patients who presented to the ED and pended for admission, who were aged over 65, with a Clinical frailty score over 4
Results
The service has seen a total of 1082 patients (8 patients a day), with an average age of 86, with an 84% discharge rate, back to the patient?s normal place of residence.
The most common presentations seen by the team were Falls, (28%), UTI (8%), CAP (5%). The team noted that there was a low re-presentation to the service, 27 patients (2.54%) within 7 days. The patients prior to the implementation of the service would have been admitted to the trust with and average length of stay of 17 days.
The potential savings to the. Trust was considered as part of the audit which compared the national and local data for length of stay and costs per day for admission and attendance to ED, which was estimated between £5,600,000 (local) - £6,000,000 (National), and if the same numbers of presentations were looked at over a 12-month period this is estimated as £9,600,000 (local) - £11,310,000 (National)
Conclusion
The service has now enabled the trust to achieve the CQUIN targets, all patients that present to FDF have a CGA started, the patients identified are less likely to be admitted with an overall estimated saving to the trust.