3201 Evaluation of a new frailty on-call shift for geriatric SpRs at St Thomas' Hospital (STH)

Abstract

Introduction Frailty-attuned acute hospital care is a vital component of integrated services for older people. The NHS Long Term Plan requires hospitals with major emergency departments to deliver 70 hours of acute frailty services each week. Workforce limitations often prevent services from meeting this target and expanding. Geriatric specialist registrars (SpRs) must gain experience in acute frailty so that the consultant workforce of the future can meet patient needs effectively. St Thomas’ Hospital (STH) Acute Frailty Service expanded hours of operation through the introduction of a frailty twilight SpR. The aim was to increase patients seen by the frailty service, enhance access to Comprehensive Geriatric Assessment (CGA) and provide learning opportunities in acute frailty. Method The twilight frailty SpR was introduced in October 2024 by re-allocating existing on-call resources, without using additional staffing. Retrospective data from April to November 2024 were analysed to compare patient numbers and service performance before and after implementation. Feedback was collected from SpRs on the learning opportunities and challenges encountered. Results Following introduction of the twilight frailty SpR, the average number of patients seen by the acute frailty team increased by 28.3%, from an average of 129 per month (April–September) to 166 per month (October–November). A survey of SpRs revealed that the majority felt twilight frailty shifts provided valuable learning experiences. Key benefits included increased autonomy and enhanced experience in CGA in an acute setting. Challenges included difficulties in discharging patients on the same day due to limited therapy support and the need for additional social care. Conclusion The introduction of a twilight frailty SpR extended acute frailty service hours and increased the number of patients receiving a CGA at the front door. SpRs have gained valuable experience in acute frailty management which is key in developing the consultant workforce of the future.