Beverley Marriott is a Advanced nurse practitioner working in the Birmingham community healthcare foundation trust. She is also a King’s College Older Person Fellow.
There continues to be a growing emphasis on older people and emergency hospital admissions, with Frailty often used as a ‘wrap’ around term for ‘older people’. Older people with multiple complex comorbidities are a growing number of emergency attendances, hospital stays and admissions.
Frailty defined as a loss of physical and psychological reserves, which means an increased vulnerability to minor stressor events. People living with frailty can often go unnoticed until they reach crisis point as many people with frailty are not necessarily known to their community services, acute care, voluntary sectors or GPs. Is A&E the only place for frail patients to go when they hit crisis?
BCHCFT launched a rapid assessment unit as part of citywide efforts to support the prevention of people requiring hospital based care, aiming to ensure patients are given the personalised care they need in the place that best suits their needs.
The community clinical decision unit (CCDU) is dedicated to the needs of frail people offering 15 inpatient beds and a dedicated multidisciplinary team of nurses and therapists led by a consultant geriatrician. CCDU offers comprehensive geriatric assessment of patients who are referred. These patients could be from their own homes, residential or inpatient care or via referral from GPs and other professionals.
Three beds are dedicated to carrying out rapid assessments of newly arrived patients while the other 12 are available for stays of up to 72 hours while arrangements are made to discharge patients into the most suitable place of care available for their personal needs.
BCHC Services clinical director Dr Mani Balakrishnar said: “CCDU is a model of excellence in supporting frail patients” Julie Ravenhall Divisional Director for Nursing & Therapies Urgent Care Services stated “CCDU supports our frail population of Birmingham and the citywide system as offers a particular place of care to meet the needs of a particular person.” However, we continue the journey ahead to supporting frail patients in ensuring they received the right care at the right time and supporting to delivering patient centred services and care.