Older and more vulnerable patients across County Durham and Darlington are set to benefit from improved access to speciality frailty care this winter.
Leaders at County Durham and Darlington NHS Foundation Trust (CDDFT) plan to enhance and expand the acute frailty service at Darlington Memorial Hospital (DMH) by bringing together more specialist care into a new dedicated facility.
The expanded service in Darlington will build on the success of the acute frailty service already in place at University Hospital North Durham (UHND) and forms a key part of the Trust’s readiness for winter.
Around 40% of patients who attend the Trust’s Emergency Departments in Durham and Darlington have an acute frailty need. These are older people who are more vulnerable to illness or injury and can quickly deteriorate without urgent help.
Part of the Trust’s frailty service at Bishop Auckland General Hospital is planned to move to Darlington Memorial Hospital to support winter resilience plans. This will allow more consistent access, 7 days a week to specialist frailty care with consultant input and earlier senior decision-making 24/7. All other step-down care and specialist inpatient rehabilitation and frailty care for older people will continue at Bishop Auckland General Hospital as usual.
Although the changes are part of the Trust’s winter plans, healthcare leaders will work closely with patients, families and carers over the winter period to evaluate how well the transition to a new 7-day acute frailty service works and measure effectiveness.
The aim is to improve both patient outcomes and experience by making sure frail older people have the right expert assessments at the start of their journey. This will also speed up treatment and recovery, with some patients historically having to wait weeks, in a hospital bed, just for the right specialist frailty input.
Dr Eliot Sykes is the Chief Medical Officer at CDDFT. He said: “We are talking to our staff about these changes as part of our planning for the busy winter months ahead. We must make sure we look after the most vulnerable in society and avoid frail older people waiting hours in our busy Emergency Departments or being admitted to hospital when they don’t need to.
“Key to this is having the right specialists available 24/7 on both of our acute sites to assess, treat and support older people to recover and return home quickly. This can often be on the same day and without having to stay in hospital.
“Hospitals are high risk environments and people who are frail can easily develop other problems the more time they spend there. We see people start to lose their muscle strength, mobility and, sadly, their confidence to remain independent. We don’t want this for anyone’s loved ones.”
Bishop Auckland General Hospital will also play a key role this winter to protect care for those who are waiting for planned operations. The hospital is one of just six surgical hubs across the North East and North Cumbria having received national accreditation from the Royal College of Surgeons and Royal College of Anaesthetists in July this year.
As an accredited surgical hub, it means the Trust is working to the highest standards of clinical and operational practice to deliver faster access to common surgical procedures. Being separate from emergency care also greatly reduces the risk of short-notice cancellations, especially during winter.
Dr Eliot Sykes added: “These changes are not something that people should fear. This is about improving how the NHS works to provide more care in the right place, in the right way. Many older people do not need to be admitted to hospital, but that’s where they end up because we don’t have alternative pathways in place to look after them. This is the whole focus of the NHS 10-year plan and how we move more care out of hospitals into the community and people’s own homes.”
The Trust’s acute frailty services work alongside ‘Hospital at Home’ teams in Durham and Darlington. These services provide hospital-level care including detailed monitoring and tests, along with visits from medics, in someone's own home.
To support its winter plan, there will also be some ward moves within Darlington Memorial Hospital to create the space for the new dedicated acute frailty facility. Discussions are underway with staff affected and the Trust is working with trade union partners to support colleagues going through the organisational change process. There are no planned job losses, but some staff may see changes to their role, ward or place of work. There may also be new roles and opportunities for staff.
The Trust’s winter plans were approved by the Board at its meeting on 24 September. The aim is for the new acute frailty service to be in place at Darlington Memorial Hospital by Christmas and in readiness for the winter surge in January.
A full evaluation of the Trust’s expanded acute frailty service will take place in spring and include feedback from patients, families, carers and staff.