NHS Benchmarking Network and Wessex Academic Health Science Network (AHSN) held a collaborative workshop on Tuesday 26th February 2019: Is Wessex Frailty Fit? The event brought together Wessex Trusts alongside national bodies, including the Royal College of Nursing (RCN) and NHS England, to discuss frailty in the Wessex region and local action planning to create service improvement plans.
Wessex AHSN CEO, Bill Gillespie, opened the event and welcomed Professor Martin Vernon, National Clinical Director for Older People, NHS England, to the lectern. Martin’s presentation focused on the national context for those living with frailty, referencing the NHS Long Term Plan and its aims to “drive up quality and embed meaningful care for…[those] at risk of frailty”.
The three national priorities are:
Change in approach to health and social care nationally
Preventing poor outcomes through active ageing
Quality improvement in existing acute and community services
You can read more about Martin’s recommendations via #wessexfrailtyfit, where discussion about hospital targets, the Ageing Well programme and delirium recovery programmes in the community are explored.
Next to the lectern, we welcomed Dr Adrian Hopper, (Getting It Right First Time) GIRFT Lead for Geriatric Medicine. The presentation highlighted why it is important to know where patients living with frailty are located within an acute hospital setting to ensure the best outcomes for them; responding to the first aim of the workshop: Do you know how many people, who are living with frailty, are in your hospital today and where they are located?
The Geriatric Medicine GIRFT workstream is still in its infancy, but is building a fascinating picture for service improvement in this area, especially with the additional investment from the NHS Long Term Plan. We’re excited to see what’s to come from this ongoing work and how it will shape local action plans.
Kathy Wallis, Associate Director, Strategic Programmes from the Wessex AHSN then introduced the Wessex Frailty Audit, a locally designed audit, based on NIHR Dissemination Centre themed review, “Older people living with frailty in hospital” to benchmark services against evidenced best practice for the identification and management of people living with frailty who are admitted into hospital, with the aim of reducing the unintended variation of care and therefore increasing the quality of care across the region. The Audit investigates the processes applied across hospital specialities to identify how care is focused on the patient living with frailty.
Complementing this piece of work, the NHS Benchmarking Network was commissioned to complete a Wessex cut of the national Managing Frailty in the Acute Setting data, focusing on the pathway of frail older people. This also included a Service User Audit, which was developed with the British Geriatrics Society.
Following a networking break, we moved straight into the workshop sessions, focusing on Screening & Identification, before moving onto Management & Discharge, and closing with the topic of Training & Workforce. A summary of the data was shared prior to table discussions exploring the following:
What does the data tell us?
Where are the gaps?
What are the opportunities?
On topic 1, Screening & Identification, John Duffy, Consultant from Hampshire Hospitals NHS Foundation Trust highlighted Wessex Frailty Audit findings, which showed that screening for frailty happens at the emergency front door, but rarely for direct ward admissions or after admission.
On topic 2, Management & Discharge, the NHSBN dataset showed that Wessex are higher than the national average for older people having a CGA (Comprehensive Geriatric Assessment) started within one hour of admission, but there is still opportunity for improvement. Consultant Frailty Practitioner Trainee, Lucy Lewis described how the Wessex Frailty Audit identified that wards with access to a Frailty Specialist Nurse are more likely to produce care plans for people living with frailty.
The final topic, Training & Workforce, was led by Harnish Patel, Consultant Geriatrician at University Hospital Southampton NHS Foundation. This session gave rise to questions from the floor about skill mix within Wessex Trusts, as well as access to frailty teams. A service improvement opportunity was also recognised following data from the NHSBN collection, showing that Trusts in Wessex provide a lower percentage of frailty identification and awareness compared with the national average.
The workshop provided an excellent insight into Wessex activity in frailty, evidenced by the Wessex Frailty Audit and NHSBN Managing Frailty project. There was also the opportunity to experience what it’s like living with frailty using a VR headset.
The day was a great opportunity to share good practice and be inspired to implement local plans. Thank you to all who attended in both a speaker, facilitator and delegate capacity. You can keep up to date using #wessexfrailtyfit.
If you have any queries about the Wessex Frailty Audit, please contact Cheryl Davies, Healthy Ageing Programme Manager at Wessex AHSN.
If you have any queries about the NHSBN Managing Frailty project, please contact Josh Davies, Project Coordinator.