3849 The case for space: does a dedicated frailty same day emergency care (F-SDEC) unit improve the impact of an acute frailty team?

Abstract Background National and local standards in acute frailty recommend a seven-day service, with front-door assessment and a dedicated frailty area. Many acute frailty teams struggle to maintain a dedicated space as they are vulnerable to becoming inpatient areas when bed pressures increase. The Acute Older Persons Unit (AOPU) at Guys and St Thomas has faced similar challenges and is based on the Acute Admissions Ward and the Emergency Department. This project assessed whether a dedicated Acute Frailty SDEC (F-SDEC) space increased the number of patients seen and the number of same-day discharges. Methods The AOPU was based in medical SDEC for a trial period of 16 weekends from 23nd February 2025 (F-SDEC). Th F-SDEC space has recliner chairs and consultation rooms but no beds or sluice meaning the referral criteria had to change excluding those who required two to transfer or needed a commode. Data was compared between the 3 weeks prior and for 5 weeks following the implementation of F-SDEC. Results The average number of new patients seen per weekend increased from 8 to 14 during F-SDEC. The number of same day discharges increased from 9/24 (37.5% of patients seen) to 33/62 (53.2% of patients seen). The mean clinical frailty score (CFS) decreased from 6.1 to 3.9. The most common presentation was falls (45.3%) pre-F-SDEC and falls (20.3%) and infection (20.3%) during F-SDEC. Conclusions F-SDEC increased the number of patients seen and the number of same-day discharges. The average CFS decreased due to the space not being suitable for the most frail patients. When advocating for space frailty services need to balance ambulatory requirements with the ability to serve the most frail patients. A dedicated F-SDEC area that accommodates the most frail patients has the potential to increase same day discharges and improve capacity across the system.