Abstract
Background: The NHS Long Term plan calls for change to deliver proactive community frailty care1. Proactive frailty case-finding outside traditional healthcare settings should be explored2.
Aims: To pilot test proactive frailty screening at a community event. Methods: GSTT Musculoskeletal Physiotherapy department hosted a community day in a deprived area of Lambeth, London. Waiting list residents were invited for a café-style assessment. Stalls were available to meet wider needs including finances, wellbeing, Ageing Well and others. Ageing Well (Consultant Geriatrician & Geriatrics trainee) completed frailty screening using a 1-page screening tool with follow on assessment/interventions. Accessibility evaluated by characteristics of attendees. Feasibility and acceptability evaluated by participation and assessment completion. Appropriateness by prevalence of frailty needs, number of interventions arranged.
Results: 137 residents accepted, 26 (19%) were 65+ years old. 14 residents were reviewed by Ageing Well. Mean age 67 years (57-80), mean 4 comorbidities, 72% from ethnic minority groups, mean Clinical Frailty Scale (CFS) 4 (range 2-5). 43% were digitally excluded (unable to use internet or phone). All 14 residents participated freely in an open setting suggesting acceptability including sensitive topics e.g. continence/mental health. The Frailty screening tool identified significant needs: pain (93%), fatigue (64%), falls (50%), mental health concerns (64%), medication management (50%), bladder concerns (50%), difficulties with activities of daily living (57%), financial concerns (43%). 43% attended ED in the last year. Only 1 was known to social services but 43% had informal help from friends/family. Personalised care plans included bone health interventions, medication changes, continence management, strength/balance exercises programme access, equipment provision, social services access, self-management advice/information .
Conclusions: Ageing Well screening & assessments appeared feasible, acceptable, accessible and appropriate to managing frailty needs proactively in ambulant vulnerable-mildly frail residents. This proactive outreach approach should be explored at alternative outreach events.