Media Release: Pioneering project focusing on the needs of frail elderly

A PIONEERING project is being credited with delivering improvements in the care of frail, older patients in Scottish hospitals.

Healthcare teams from hospitals in four health boards have been piloting a range of new approaches, which focus on early identification and the specialist assessment of frail, older people.

The initial results from the Focus on Frailty project show significantly improved patient outcomes, specifically reductions in admissions and re-admissions to hospitals.

The Focus on Frailty project is another ground-breaking initiative led by Healthcare Improvement Scotland – in collaboration with teams from across NHS Scotland – to ensure that every patient in NHS Scotland receives the best possible care.

However, the successes achieved are being seen as a pointer to ensure that Scotland’s growing numbers of frail, older people have their healthcare needs met in a more timely and consistent way.

Over the coming year, Healthcare Improvement Scotland will continue to work with teams from across NHS Scotland to build on these achievements, to continue testing in order to consolidate improvements in care, demonstrate outcomes from test-sites and share and spread learning to other teams while working closely with other national work-streams to improve care for frail older people.

As well as improvements to the patient experience, early findings also identified potential cost saving opportunities, which could be a huge boost for the sector with the over 65s as a percentage of the population, expected to rise by more than six per cent by 2035.

Penny Bond, from the Older People in Acute Care (OPAC) team at Healthcare Improvement Scotland, said: “Frailty is complex but the early evidence from our work tells us that when frail older people are identified rapidly and have a comprehensive assessment process carried out, outcomes can be improved.

“The project was initially set up with the objective of improving care for older people in acute care (typically hospitals) and the work that the teams across Scotland have undertaken highlights significant improvements for frail older people coming into hospital.

“These outcomes include reduction in admissions and re-admissions to hospital, reduction in length of stay and reduction in discharge to care homes.

“On top of this boards have reported positive feedback from the staff involved in the work, with enhanced team-working all round.”

The Healthcare Improvement Scotland project saw hospitals based in NHS Ayrshire & Arran, Grampian, Lanarkshire and Lothian Health Boards develop a simple set of criteria for immediately screening and identifying individuals who are frail, which would then be swiftly followed by a Comprehensive Geriatric Assessment (CGA) – a specialist assessment process carried out by a multi-disciplinary team to support setting of individual goals.

The common themes found across all boards were:

  • Adopting an easy to use frailty screening tool enables the faster referral of further assessment and increases the number of frail older patients correctly referred to specialist beds.
  • Reduced admissions, shorter hospital stays and fewer discharges to institutional care.
  • Reduced pressure on beds and increased capacity.
  • Healthcare teams highlighted the benefits of working together as a specialist team focused on the early identification and assessment of frail patients.

Specifically, in NHS Ayrshire & Arran, there was a reduction in the time taken for frail older people to be assessed and referred to specialist services.

The region noted consistently good feedback from patients and carers, while another interesting indirect benefit identified was improved waiting times in the accident and emergency department. The specialist team were so impressed by the first week of the pilot they increased the project to run for six months.

The Lothian team reported that older patients were moving to the appropriate wards more quickly, re-admissions and complaints decreased while relatives’ confidence in care had risen.

Penny Bond added: “If care for frail older people is not co-ordinated appropriately there is a human cost not just for those individuals but for their families.

“It is crucial to get care right for frail older people as soon as possible. Identifying someone early is the start of a process that should lead to the right quality of care in the right environment.” 

About Healthcare Improvement Scotland

Healthcare Improvement Scotland is a health body created by the Public Services Reform (Scotland) Act 2010 with the key responsibility to help NHSScotland and independent healthcare providers deliver high quality, evidence based, safe, effective and person-centred care; and to scrutinise services to provide public assurance about the quality and safety of that care.

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Contact: Linsay Robertson