Elderly patient

Teaching hospital creates direct admissions for frail patients

Lancashire Teaching Hospitals (LTH) NHS FT has worked with a wide range of partners, including the North West Ambulance Service (NWAS), local GPs, and community frailty nurses to develop a new ‘direct admissions pathway’.

In the first six working days of using the new system, five patients were admitted to hospital without attending an Emergency Department, while alternative arrangements were put in place to avoid hospital admission for one patient.

Development of the new pathway was created through the work of the ‘Frailty Big Room’ team, a project set up to drive innovation in services aimed at people with frailty issues.

The concept brings everyone involved together to deliver a collaborative service intended to find innovative solutions.

LTH Lead Frailty Practitioner Hazel Wright, said: “We are delighted to have opened up our unit to direct admissions from NWAS. This takes out the need for the patients to wait in the emergency department, and they have early access to a comfortable bed. 

“We use a multidisciplinary approach and complete a comprehensive geriatric assessment addressing not only medical, but also psychological, environmental and social aspects of care.”   

LTH Deputy Director of Nursing, Midwifery and Allied Health Professionals Catherine Silcock, said: “Development of this new pathway reduces pressure on our Emergency Departments and ensures patients with frailty issues can get timely and efficient access to the care they need.

“This is innovative, shows joined up working, is best for the patients and I am very proud to work with such an inspirational team.”

 “The principles of working in this way includes a flattened hierarchy, because it is important that we work collaboratively to reach consensus on how to improve the way various services and teams work together.”

The new direct admission pathway is the latest improvement developed by the Big Room Team.

Other developments introduced by the team have included the opening of a 10-bed Acute Frailty Assessment Unit at Preston Hospital, launch of daily team meetings involving community staff, and development of a virtual frailty ward.

NWAS Clinical Lead for the initiative, and Advanced Paramedic Shaun Tierney, said: “We see many older people in the community who would benefit from the support of the team on the Acute Frailty Unit.

“This direct route means they don’t have to wait to be seen in the Emergency Department, which is a better experience for the patient and makes sure they get the right care more quickly.

“This is a great example of working together to provide the best care for our patients.”

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