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. 2022 Jan 3;22(1):19.
doi: 10.1186/s12877-021-02679-9.

Frailty assessment and acute frailty service provision in the UK: results of a national 'day of care' survey

Thomas Knight  1   2 , Catherine Atkin  3 , Finbarr C Martin  4 , Chris Subbe  5 , Mark Holland  6 , Tim Cooksley  7 , Daniel Lasserson  8   9
Affiliations

Frailty assessment and acute frailty service provision in the UK: results of a national 'day of care' survey

Thomas Knight et al. BMC Geriatr. .

Abstract

Background: The incorporation of acute frailty services into the acute care pathway is increasingly common. The prevalence and impact of acute frailty services in the UK are currently unclear.

Methods: The Society for Acute Medicine Benchmarking Audit (SAMBA) is a day of care survey undertaken annually within the UK. SAMBA 2019 (SAMBA19) took place on Thursday 27th June 2019. A questionnaire was used to collect hospital and patient-level data on the structure and organisation of acute care delivery. SAMBA19 sought to establish the frequency of frailty assessment tool use and describe acute frailty services nationally. Hospitals were classified based on the presence of acute frailty services and metrics of performance compared.

Results: A total of 3218 patients aged ≥70 admitted to 129 hospitals were recorded in SAMBA19. The use of frailty assessment tools was reported in 80 (62.0%) hospitals. The proportion of patients assessed for the presence of frailty in individual hospitals ranged from 2.2 to 100%. Bedded Acute Frailty Units were reported in 65 (50.3%) hospitals. There was significant variation in admission rates between hospitals. This was not explained by the presence of a frailty screening policy or presence of a dedicated frailty unit.

Conclusion: Two fifths of participating UK hospitals did not have a routine frailty screening policy: where this existed, rates of assessment for frailty were variable and most at-risk patients were not assessed. Responses to positive results were poorly defined. The provision of acute frailty services is variable throughout the UK. Improvement is needed for the aspirations of national policy to be fully realised.

Keywords: Acute care; Acute frailty unit; Frailty; Same day emergency care.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A Bar plot summarising the proportion of patients aged ≥70 screened within participating hospitals B Scatter plot demonstrating the relationship between the number of patients aged ≥70 admitted to each individual hospital and the proportion of patients assessed for frailty
Fig. 2
Fig. 2
Bar plot summarising number of patients screened for frailty and the outcome of screening stratified by age
Fig. 3
Fig. 3
Venn diagram demonstrating the provision of acute frailty services and use of frailty assessment tools
Fig. 4
Fig. 4
Boxplots demonstrating the proportion of patients achieving same day discharge and the proportion of patients requiring inpatient admission > 7 days within individual hospitals stratified by use of frailty assessment tools and the presence of AFUs
See this image and copyright information in PMC

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