Older person assessment unit (OPAU) - A frontier to tackle frailty at the front line

Abstract

Introduction: Older and frail patients are main service user in NHS, often having subtle presentations with geriatric syndromes. Complex interplay between medical and socioeconomic issues causes significant uncertainty to care providers leading to significant delays in care delivery and risk of hospital admission disproportionately.It is, therefore, essential that their care is provided by a specialist team in a dedicated clinical area with the system in place for direct conveyance with timely assessments of these patients outside busy emergency departments at the point of presentation, preventing subspecialist care, avoiding hospital admissions where possible, and care provision outside the hospital, in or closer to their homes. Methods: OPAU established in October 2022 in the existing purpose-built Clinical Assessment Unit (CAU).Monday to Friday 8–4 operational hours.Team: Consultant Geriatrician lead, physician associate, and junior doctor.Readily available MDT ad hoc use based on patient needs.Direct telephone referrals to OPAU from southeast coast ambulance service (SECAmb) before conveyance to the hospital.Patients presented to ED out of hours seen by medical team and OPAU patients seen by frailty team; data collection from Nov 2022 and April 2023 for those presenting with falls. Conclusion: Patients in OPAU were seen quickly, were more likely to be discharged same day, with short admission if required, and were less likely to be readmitted within 30 days.We proposed dedicated assessment areas with extended hours of operation, direct conveyance as the way forward to tackle frailty effectively in our busy hospitals.