In addition to being shortlisted for the HealthTech Partnership Award of the year, the integrated frailty service in South Warwickshire University NHS Foundation Trust (SWFT), in partnership with Consultant Connect, recently featured in NHS England’s latest delivery plan for recovering urgent and emergency care services as an example of how to expand and better join up new types of care outside hospital. You can read the case example on page 36 of the latest guidance.
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Example: Integrated frailty service in South Warwickshire University NHS Foundation Trust (SWFT)
South Warwickshire University NHS Foundation Trust has created a frailty model, joining up hospital-based secondary care expertise and a dedicated assessment service with community nursing and virtual wards. This provides an integrated service that aims to keep people with frailty safe and well at home, avoid hospital admission if possible, and provide a seamless transition to secondary care if it becomes necessary.
Ambulance crews are able to contact the Acute Frailty Service via Consultant Connect, whilst with the patient at their home, followed by a triage consultation with Consultant Geriatrician input. The most suitable outcome for the patient is agreed, for example inclusion on a virtual ward for observation and monitoring and/or further face-to-face assessment by a consultant or community advanced clinical practitioners.
So far, this has led to a 50% reduction in ambulances conveying patients aged over 75 to ED and gives frail older adults an alternative to hospital admission. In addition, the Trust makes follow-up calls to all patients discharged over 75. These calls provide an opportunity to see how the patient is, answer any questions they may have and have proven to reduce re-attendances from 15% to 3%. It also grows relationships with, and upskills, community teams.
NEW – Video Case study: Integrated Frailty Service
The Consultant Connect team went on-site to capture first-hand from clinicians and staff at SWFT and WMAS how the integrated frailty service is helping to ensure frail older adults in crisis avoid unnecessary hospital admission. Watch the short video below: