Frailty Service

The Trust’s Frailty Service works with elderly patients presenting to Sunderland Royal Hospital’s Adult Emergency Department or Integrated Admissions Unit. The team provide effective, holistic and timely assessments to ensure patients receive the right care in the right place.

The Frailty team are part of the Care of the Elderly department.

The City Hospitals Sunderland Frailty team provides an in-reach service to the Integrated Admissions Unit and Emergency Department. The aim of the team is to provide a Comprehensive Geriatric Assessment (CGA) to all frail patients admitted to hospital. CGA is the gold standard for the management of frailty in older people. It involves a holistic, multidimensional, interdisciplinary assessment of an individual by a number of specialists of many disciplines in older people’s health and has been proven to improve patient outcomes in many settings. The frailty team aims are based on the ‘Fit for Frailty’ guidance, as set out by the British Geriatric Society (BGS). Patients are referred to the team when presented at Sunderland Royal Hospital.

The frailty team work closely with the complex discharge team and interface (therapy) team and are comprised of:The frailty team work closely with the complex discharge team and interface (therapy) team and are comprised of:

  • Consultant Geriatricians
  • Advanced Pharmacist Practitioners (APP)
  • Specialist Nurse Practitioners
  • Junior doctors

Early comprehensive geriatric assessment has improved patient outcomes by ensuring frail patients get the right care in the right place at the right time. Close working with front of house services has raised the awareness of frailty and challenged attitudes to the inevitability of hospital admission.

Existing evaluation has shown that the interventions of the team have resulted in reductions in the length of stay in hospital, readmission rate, need for cannulas and catheters and improved review of patients’ medications. The team has established methods of communication with primary care (both GP and pharmacy) services via the discharge summary and care plan and the use of the newly established pharmaoutcomes link.

We have worked with Sunderland University pharmacy students who have completed undergraduate projects in frailty and the University is currently working on a research bid which will focus on the work of the frailty team.

Published work can be found here (p57)

and here (abstract no 31)

The services core hours are between 08:30 and 16:30 Monday to Friday.

The Frailty Service is located at City Hospitals Sunderland Adult Emergency Department and Integrated Admissions Unit. This can be accessed through the Adult Emergency Department entrance on Kayll Road, or C level, Hylton Road Block.

Divisional General Manager Angela Gillham

Directorate Manager Laura Berry

Clinical Director Dr Nik Majmudar

Matron Carol Gibson

Matron June Lawson

Sunderland Royal Hospital

Kayll Road, Sunderland, Tyne & Wear, SR4 7TP

Tel: 0191 565 6256

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Sunderland Eye Infirmary

Queen Alexandra Road, Sunderland, Tyne & Wear, SR2 9HP

Tel: 0191 565 6256

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