Better frailty care across Haringey and Enfield

Last year at the Whittington we saw 9,257 patients who were 75 years old or over in our Emergency Department. That accounts for almost 1 in 10 of all people who come to our ED.

In 2018, nearly 20% of patients admitted overnight were 75 or over and we know that the more frail a patient is, the more likely they are to deteriorate sooner.  We assess and plan care based on a patient’s level of frailty – which, simply put, describes how as we get older, our bodies gradually lose natural resilience, increasing the risk of sudden changes in health triggered by seemingly small events such as a minor infection or a change in medication or environment.  This is what we are doing to make sure these people get the right care at the right time.

Joining up services in primary, community and social care
We know that people with frailty can deteriorate quickly when they are admitted to hospital – for example, did you know that for every 10 days in a hospital bed leads to 10 years’ worth of lost muscle mass in people over age 80?

There are lots of services available in primary, community and social care that can prevent an admission to hospital as well as provide care at home to allow older patients to leave hospital as soon as they are medically well enough. However, we are not always good at joining these services up and ensuring that we are all working together to support people with frailty to live and age well.

That’s why colleagues from across Whittington Health NHS Trust, North Middlesex University Hospital NHS Trust Barnet, Enfield and Haringey Mental Health Trust and commissioners gathered on Wednesday (03/04/19) for our first frailty network workshop.   The aim was for people involved in caring for elderly people across Haringey and Enfield to get together, find out more about what they all do and identify how we can work better together.  

In a packed out room full of positivity, people heard from North Middlesex Hospital’s clinical lead for frailty, Dr Richard Robson who gave a presentation on what frailty is and why it’s important for all of us to understand it.

It was then onto hearing patient stories and understanding their experience of services in a hospital, in the community and through social services. It was clear that there is a lot of good work going on in different areas, but it isn’t necessarily connected. So everyone worked in groups to understand what went well, what could have been better and how we can join up services so that they work for patients.

Developing a vision for frailty care in Haringey and Enfield
People in the room identified some quick wins, including understanding the services available in Haringey and Enfield and how to access them – this was made easier because it was those in the room who ran the services. Following this, a vision for frailty care in Enfield and Haringey was discussed and everyone fed their ideas in on what it should be and the principles behind making it a reality.

The next steps are to finalise the vision and how everyone can help to deliver it. The team plan to hold another workshop in May so watch this space for more developments in how we improve frailty care for our community.