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S Brook, R Barnard, Y Al-Haddawi, A Wiggam, S Chaudhuri, M Murden, G Todorov, 2545 The burden of frailty in a West London hospital: a case for an acute ‘front door’ team with robust links with community services, Age and Ageing, Volume 54, Issue Supplement_1, January 2025, afae277.037, https://doi.org/10.1093/ageing/afae277.037
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Abstract
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 6500 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 Community Response Services.
To gather baseline data on frail patients admitted before the introduction of a ‘Front Door Frailty’ team.
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
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
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.
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