Offering older patients an ‘alternative front door’, the Ulster Hospital and Lagan Valley’s Frailty Intervention Teams (FIT) are working and most importantly reducing, the amount of older people who could be faced with time spent at their Emergency Departments.
If a patient is living with frailty, the FIT team work to identify this early in their hospital stay.
South Eastern Trust, Consultant Geriatrician, Dr Samantha Leung explained how the Frailty Ambulatory Hub service, based at Lisburn’s Lagan Valley Hospital, avoids unnecessary hospital admissions for older vulnerable patients. “We are open to primary care referrals for those patients who have conditions that are deemed more urgent than a standard outpatient appointment which can sometimes take several months.”
“It’s an alternative front door for those patients who need urgent investigations, so that they do not have to spend hours in the Emergency Department and be admitted to hospital.”
75-year-old David Watson from Lisburn availed of the service after he became unwell at home. David praised the service and the treatment he received as, “calm efficiency”.
“I was referred to the Frailty Ambulatory Hub by my GP and I waited a very short time for notification to come in. I was really struck by how calm and pleasant the team were,” said David.
“I was advised all through my assessment, what was going to happen with my treatment. I was treated as a person and it was a very reassuring experience.”
David continued, “It is stressful enough going into hospital so it is nice to have the sense of being with people who know what they are doing and to keep you informed, before, during and after. I was very much treated as a person.”
Unfortunately some hospital admissions are unavoidable, Frailty Intervention Team Sister Laura Boyle explained how in 2024, 76 per cent of the patients admitted were aged 65 and over.
“In Lagan Valley Hospital, we have three Geriatricians and we needed a way to ensure that all the patients could have specialist frailty input if required. The team assesses all patients who are admitted onto the Medical Admissions Ward and they will check their level of frailty. Those patients who are living with moderate to severe frailty will then benefit from a frailty assessment and discussed daily with our Consultants,” said Laura.
Laura added how the team works closely with the patient and their family. “Often, support is needed and by including everyone in the patient’s comprehensive assessment, we are able to develop plans and work towards a safe and effective discharge out of hospital.”
Laura continued, “The assessment allows us to put a holistic plan in place with the patient. We can help develop plans to try and avoid future hospital admissions and liaise with the GP on alternative routes of care.
“This is such a rewarding role as the patient always comes first. We are able to work so close with their families to ensure they have the correct information to make the decisions that are so important in their journey. It can be a very difficult time for many patients and we hope our involvement makes it that bit easier.”
The Frailty Ambulatory Hub has been in operation in the Ulster Hospital since September last year and operates Monday through to Friday. FIT’s Advanced Nurse Practitioner Charis Kelly stressed how it is the team’s aim to, “Initiate a comprehensive assessment early on in the patient’s admission to then facilitate earlier intervention, by the right team, at the right time.”
“Our aim is to work together with the community teams to either prevent a hospital admission or reduce the length of stay. We work to help the patient return to their home or to their place of residence as soon as possible.”
Ulster Hospital FIT Trainee Advanced Nurse Practitioner Jo Lannon added, “If a hospital admission is required, we will work alongside other healthcare staff to review all aspects of that patient’s health. Care and treatment is tailored specifically to that patient and their views are vital.”
