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Frailty services helping older adults stay well at home

  • 4 min read

Frail older adults in West Dunbartonshire are having shorter stays in hospital and are less likely to be re-admitted, thanks to the improving frailty services in the Vale of Leven Hospital.

As part of these ongoing improvements, there was the creation of a new frailty practitioner post. Craig Bowman took up this post in July 2018, coming from a background in physiotherapy with experience working across NHS Greater Glasgow and Clyde. 

The aim of this new post is to improve the outcome of frail older adults who attend the Vale of Leven Hospital, and since then the hospital has seen a drop in seven day re-admission rates, from 6% to 2%, with 29% of patients who receive input from Craig being discharged on the same day.

Since the new frailty pathway was introduced, the percentage of frail older adults receiving a Comprehensive Geriatric Assessment has also increased from 44% to 77%, improving the quality of care.

Craig said: “When I meet my patients and explain my role, I often say that whatever has unfortunately brought you into hospital, we will also take the opportunity to identify other small problems which may be affecting your quality of life. So we can try and help with these so they don’t become bigger issues in the future.  This helps patients and their families to identify with my role and helps put them at ease.

“My job is to assess frail patients over the age of 75, or 65 if they live in a residential care setting.  I work with the multi-disciplinary teams across the hospital to help manage their inpatient treatment and plan for a patient’s discharge back home at an early stage of their admission, working with physios, occupational therapists and nursing staff, as well as relevant community teams.

“Frailty is not just about mobility but covers a whole range of things. It’s really about a person’s ability to cope with everyday activities and their reserve against disease, trauma and infection.”

An average days for Craig sees him working between the Medical Assessment Unit and the hospital’s Minor Injuries Unit – something Craig’s refers to as “the front door.”

He said: “By initiating a Comprehensive Geriatric Assessment as early in the patient’s journey as possible, the team is able to determine if hospital is the right place for someone, and if not, we try to plan the best support to help them there.

“A big part of this is working with families as they are often key in supporting someone at home. If there are concerns raised about someone being discharged home I can then link with Social Work and other community colleagues to hope to find solutions to the issues the families have.”

One of the best parts of the job for Craig is the variety of staff, both in hospital and in the community, his role brings him into contact with, combined with the familiarity a small site brings.

He said: “I love working at the Vale, it’s a great place to work. Because it is a small hospital, you really get to know the people you work with, and the local communities which the hospital serves.

“The best part of my job is being able to help someone find a solution to a problem they may have been struggling with at home, even if it is unrelated to why they were admitted to hospital in the first place – knowing that you have had a positive impact on an individual’s quality of life.

Margaret O’Rourke, Clinical Services Manager & Lead Nurse said: “Craig is a valuable member of the multi-disciplinary team at the Vale and in this new role not only has he benefited patients but also strengthened our links with wider community colleagues within the West Dunbartonshire HSCP.”