Abstract
Introduction
Global estimates indicate over half of individuals aged 85 and older are frail (1), costing the UK healthcare system approximately £5.8 billion annually(2). Locally, over 6,500 patients aged 65+ are admitted to West Middlesex University Hospital (WMUH) every six months. The proposed frailty team aims to implement early comprehensive geriatric assessments (CGAs) through a multidisciplinary approach. Timely CGAs can increase the likelihood of patients remaining in their own homes at 6 and 12 months(3), reduce length of stay (LoS), and lower healthcare costs, contingent upon available community infrastructure. WMUH serves multiple boroughs, necessitating coordination with various community services to support discharges. These services include Hospital at Home and Integrated Care Response Services.
Objective
To gather baseline data on frail patients admitted before the introduction of a 'Front Door Frailty' team.
Methods
Data were collected for all medical admissions to WMUH from 1st to 14th July 2022, including:
• Patients aged ≥65 years
• Numbers with a frailty syndrome
• Clinical Frailty Score (CFS)
• Admissions in the previous year
• Length of stay
• Mortality at 5, 9, and 12 months
Results
From 459 admissions over 2 weeks, 278 patients (61%) were ≥65 years old. Among these patients:
• 54% had a CFS ≥ 6
• 44% presented with a frailty syndrome
• 83%, 72%, and 67% were alive at 5, 9, and 12 months respectively
• Mean LoS was 11.0 days
• 37% had ≥1 admission in the following 6 months
• Of those with a CFS ≥ 6, 63% had ≥1 admission in the previous year
Conclusions
A high percentage of acute admissions at our hospital are characterised by frailty. Through early identification, multidisciplinary management, and improved links with local community services, the new acute frailty team aims to decrease length of stay and improve patient experience.