Understanding Leighton Hospital's Frail Elderly Assessment Unit (FEAU)
The Frail Elderly Assessment Unit (FEAU) at Leighton Hospital is a dedicated service designed to address the specific and often complex needs of older, frail patients. It was established by the Mid Cheshire Hospitals NHS Foundation Trust to tackle the issue of frail elderly patients spending longer than necessary in the Emergency Department (A&E). Unlike a standard A&E department, the FEAU focuses on a holistic, rapid assessment to determine the best care pathway, with the primary goal of avoiding a hospital admission where possible.
The Mission of the FEAU
The central mission of the FEAU is to support vulnerable patients in the local community by providing early access to rapid investigations and treatment. This approach helps prevent the negative health outcomes often associated with a prolonged and unnecessary hospital stay, which can be particularly detrimental to older adults. By focusing on swift intervention and discharge planning, the unit ensures that patients receive the care they need without entering the acute hospital system, thereby ensuring they can return to their own homes and a familiar environment as quickly as possible.
The Multi-Disciplinary Team (MDT) Approach
A key element of the frailty unit's success is its multi-disciplinary team, which works proactively and collaboratively to care for patients. The FEAU team includes:
- Consultants: Geriatric specialists who provide expert medical oversight.
- Advanced Clinical Practitioners: Experienced clinicians who assess and manage patient care.
- Dedicated Prescribing Pharmacist: Reviews patient medication to identify and resolve any issues, such as polypharmacy (the use of multiple medications).
- Discharge Nurse: Coordinates the transition from the hospital back to the patient's home or community care setting.
- Physiotherapists and Occupational Therapists (Physio/OT): Assess mobility and daily living needs to ensure a safe home environment upon discharge.
- Health and Care Professionals: Work with external agencies to arrange community-based support services.
The Patient Journey in the Frailty Unit
- Referral: A frail elderly patient may be referred to the FEAU from the Emergency Department, by a GP, or via the ambulance service following an initial assessment.
- Rapid Assessment: Upon arrival, the patient is reviewed by the MDT. Unlike a general ward, this assessment is highly focused on geriatric-specific needs and conditions, such as falls or sudden confusion.
- Treatment and Planning: The team provides prompt investigations and treatment. Simultaneously, the discharge team begins planning for the patient's safe return home, coordinating with community services as needed.
- Discharge: The patient is discharged home with a comprehensive care plan, which may include follow-up appointments, home care support, or referrals to other services.
Comparison: FEAU Pathway vs. Traditional Hospital Admission
| Feature | FEAU Pathway | Traditional Hospital Admission |
|---|---|---|
| Focus | Rapid assessment, treatment, and discharge to prevent admission. | Stabilization followed by admission for further diagnostics and treatment. |
| Environment | Dedicated unit for frail older people, often calmer and tailored to geriatric needs. | Potentially busy and overwhelming ward or A&E environment. |
| Specialization | Multi-disciplinary team with geriatric expertise (physio, OT, pharmacists, etc.). | Care provided by a general ward team, with specialist input requested as needed. |
| Length of Stay | Aims for same-day or short-term stay (1-2 days). | Often longer, depending on bed availability and need for investigations. |
| Discharge Planning | Begins immediately upon assessment, proactive and coordinated. | Can be delayed until after acute issues are resolved, potentially extending stay. |
Addressing Broader Needs: Beyond the Medical
The FEAU at Leighton Hospital understands that frailty involves more than just physical health. Recognising that issues like loneliness can affect a patient's overall well-being and recovery, the unit has actively participated in projects to address these wider needs. By assessing the prevalence of loneliness and developing social prescribing tools, the unit highlights the importance of integrating social care with medical treatment. This holistic approach ensures patients not only recover from their immediate illness but also have the necessary community support to thrive after discharge. For more on this, read the Mid Cheshire Hospitals' update: Leighton Hospital's Frailty Unit marks one-year milestone.
The Positive Impact on Senior Care
The establishment of the FEAU at Leighton Hospital is a significant step forward in providing high-quality, person-centred care for the elderly. By shifting the focus from hospital admission to proactive community-based care, the unit has demonstrated impressive results, saving thousands of bed days and improving patient experience. This model serves as an excellent example of how specialized units can enhance the lives of vulnerable older adults while optimizing hospital resources, ultimately leading to better health outcomes and a more dignified care journey.
